The 2014 Survey of American’s Physicians sponsored by The Physicians Foundation is chock full of information that reflects the state of physician happiness in the country. And, although the response rate to the survey was low at 3.1% (20,888 respondents/640,000 who received the survey via email), the methodology of the survey was blessed by the College of Business Administration at the University of Tennessee noting a low error rate “so the result can be interpreted with confidence.”
When examining the results, we have to remember that compared to the last Survey in 2012, there have been many significant changes in healthcare starting with the enrollment of many millions of people via the Affordable Care Act and the expansion of Medicaid. Hospitals have been gobbling up physician practices at a rapid rate so that now more than half of physicians in the survey describe themselves as hospital or medical group employees, up from 44% in 2012 and 38% in 2008. Eighty-five percent of physicians are now using EHRs compared with 70% in 2012. And, docs are feeling the pressure of the physician shortage with 81% saying they are overextended or at full capacity (up from 75% in 2012). Only 19% of physicians say they have time to see more patients.
How do docs feel about the medical profession?
Keeping the rapidly changing healthcare landscape in mind, let’s see what physicians are saying about their happiness by looking at their responses to questions about how they feel about the medical profession.
When asked what best described their professional morale and feelings about the current state of the medical profession, more than 44.4% reported feeling somewhat or very positive, up from 31.8% in 2012. Almost half of respondents said they were somewhat or very positive/optimistic about the future of medicine (up from 22.6% in 2013). Equally important, the percent of physicians reporting being very negative/pessimistic about the future dropped from 31.5% to 11.6%. Most physicians (71.3%) said they would still choose to be a physician if they could choose their careers all over again and half (49.8%) said they would recommend medicine as a career to their children or other young people—both increased from 2012 when the results were 66.5% and 42.1%, respectively.
Parsing the data
The survey drilled down to how different characteristics (e.g., age, gender, professional status, primary vs. specialty care) impacted the results. Here is what they found:
Age (<45 or >46)
Younger docs have better morale than older docs with 54.2% being somewhat or very positive about the current state of the profession and 55% feeling the same about the future state. That compared to 38.9% and 45.8% respectively for older docs. About the same percent in each said they would still choose to be a physician and slightly more younger docs (51.1% vs. 49.2%) said they would recommend the profession to young people including their children.
Owned vs. Owners
Believe it or not, employed physicians have more positive feelings about both the current and future state of medicine than docs who own their practice (50.5% vs. 33.1% and 53.2% vs. 40%). They are also more likely to say they would choose medicine all over again and recommend it to young people.
Women are happier about the current state of medicine than men (48.6 vs. 42.4%). They are also more positive about the future (55 vs. 45.8%). They are slightly more likely to choose medicine as a career again (72.4 vs. 70.8%) but, interestingly, only as likely as men to recommend medicine as a career to young people.
Primary care or Specialist
Although many more primary care physicians are somewhat or very positive about the current state of the medical profession compared to specialists (50.2% vs. 40.7%), they are almost equally positive about the future (48.9% vs. 47.4%). Primary care physicians would choose to do it again at a higher rate than specialists (74.2 vs. 69.8%) and would also recommend it to young people more often (53.8% compared with 47.4%)
So, what does this tell us?
If the results of this survey hold up (we are not provided with the statistical significance of the reported differences), I think it bodes well for the future of medicine. The older, less happy, more male doctors are, most likely, going to retire soon leaving the younger, more satisfied docs in the workforce. Providing the young ones don’t get jaded as they grow older (and there are no guarantees this won’t happen), perhaps we will see the profession inching its way back up the professional satisfaction scale.
More to come
There’s lot’s more data to mine in this 68-page report, including how docs feel about the ACA (a.k.a. Obamacare), new models of care (accountable care organizations or ACOs), and concierge medicine. Check back in the coming days to see what else the nation’s doctors are thinking.