Most physicians feel some level of burnout, hassled by electronic health records and lost autonomy. No wonder, then, that a majority of doctors favor some type single payer health system — one-quarter fully single payer, a la Britain’s National Health Service; and another one-third a single payer combined with a private insurance option, discovered in the 2018 Survey of America’s Physicians report on practice patterns & perspectives, published by The Physicians Foundation.
Eight in ten physicians are working at full-capacity or are over-extended, the survey found. Furthermore, 62% of doctors are pessimistic about the future of medicine.
Physician burnout is a real challenge to the U.S. healthcare system and, thus, patient care. This year’s annual Medscape poll of physicians was titled “the National Physician Burnout and Depression” report to call out this top-line finding.
This is sobering through just the N=1 physician lens. But consider the statistic that, according to the Association of American Medical Colleges, there will be a shortage of 65,500 physicians expected in 2020, and 90,400 in 2025.
Contributing to this expected physician deficit is the expectation that 46% of doctors plan to change career paths.
Other studies on physician sentiment have found that the adoption of EHRs have negatively impacted workflow and, therefore, practice productivity — which is the financial lifeblood of a physician’s living. About one-quarter of physician-time is spent on non-clinical paperwork, Physicians Foundation found.
The loss of clinical autonomy, through strict utilization review, protocols, and heavy-handed health insurance interventions also contribute to doctors’ ill feelings and compromised productivity.
Health Populi’s Hot Points: We now call upon our physicians to also be health economists, evaluating patients’ social determinants of health — personal factors related to poverty or other social conditions. About 9 in 10 doctors say at least some of their patients have a serious health problem that’s linked to a social determinant.
Here’s a New Yorker cartoon I’ve used in my meetings for over ten years. Physician burnout is not new; it’s normal.
Physicians said that patient relationships “far exceed” other sources of professional satisfaction like status or compensation. This, too, is a norm among most doctors polled in previous Medscape studies.
So what do we do with this single-payer idea? The U.S. has the opportunity to envision a new-and-improved healthcare system that’s really a “system.”
Across political party, most Americans also favor some flavor of universal health insurance.
That’s an idea on which doctors and patients can hug.