Poll Underscores Continuing Job Dissatisfaction Among Primary Care Docs

M3 USA, parent company of MDLinx, a medical market research firm, today released the results of its annual poll of US primary care physicians. Conducted at the close of 2010, the survey of 3,729 family care physicians found that 40.3% considered leaving their primary care practices, with 16.5% reporting that 2010 was the first year they had considered such a career change.

“The poll results are not surprising given the rising financial pressures for family practices,” said Craig Overpeck, chief operating officer of M3 Global Research. “Only 15.6% hold out hope of 2011 being a better than average year for their personal income, with 17.7% forecasting 2011 to be one of the worst earning years of their career. The survey also reported only three out of five physicians enjoying better job satisfaction than they anticipated on their first day in medical school.”

“The growing avalanche of paperwork, insurance bureaucracy, office overhead expenses, and challenges of small business management have many practices reeling,” said Stephen Smith, chief strategist for M3 USA. “The most satisfying element of the job for many doctors is face-to-face time with patients, and that has been eroding steadily for the past decade. This trend is very disquieting for a crucial national profession already suffering increasing shortages of primary care physicians.”

The results of this newest poll reflect those of earlier surveys. In 2008, nearly half of primary care physicians responding to a survey by The Physicians’ Foundation said they planned to reduce the number of patients they see or stop practicing entirely within three years.

In addition, 94% said the time they devote to nonclinical paperwork has increased, and 63% said that paperwork has caused them to spend less time with patients. In addition, 78% said they believed there was a shortage of primary care doctors in the United States today, while the same percentage said medicine is either “no longer rewarding” or “less rewarding.”

The survey was mailed to 270,000 primary care physicians and more than 50,000 specialists, and returned by 11,950 physicians. “Declining reimbursement” rated highest on the list of problematic issues, followed by “demands on physician time.”

“I am burned out,” one physician wrote in response to the survey. “My income is so low (because I spend so much time with patients and therefore see fewer) that I am in debt. It is disgraceful and disgusting that doctors who save lives (and who bear that responsibility) are treated the way we are.”

Ironically, the newer survey came out the same week that the American College of Physicians (ACP) revealed that there was an increase in the number of US medical students choosing internal medicine residencies in 2011.

The 2011 National Resident Matching Program report showed an 8% increase from last year, with 2,940 US seniors at medical schools enrolling in an internal medicine residency program, compared to 2,722 in 2010. This is the second consecutive year that internal medicine enrollment numbers have increased. This trend follows a two year decline from 2007 to 2009 (2,680 in 2007; 2,660 in 2008; and 2,632 in 2009).

“This is good news for internal medicine and adult patient care in the US,” J. Fred Ralston, Jr. MD, president of the ACP, said in a statement. “The American College of Physicians has consistently called for health care reforms that support internal medicine as a career path, including increasing support for primary care training programs, increasing Medicaid and Medicare reimbursement to primary care physicians, and expanding pilot testing and implementation of new models of patient care.”

The 2011 match numbers include students who will ultimately enter a subspecialty of internal medicine, such as cardiology or gastroenterology. Currently, about 20% to 25% of internal medicine residents eventually choose to specialize in general internal medicine, compared with 54% in 1998.

HCPLive wants to know:

Are you satisfied with being a primary care physician?Why or why not?What do you think the main reasons are for dissatisfaction among primary care physicians?Would you advise a medical student to go into primary care?

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