A Remedy for Physician Unhappiness
A 2019 survey of 5000 physicians done by AAFP and CompHealth revealed some not so surprising data. The survey determined what qualities in their work environment made them most happy but in doing so were able to determine the factors that caused the most unhappiness. I will focus on the top 3 reasons for physician unhappiness.
#1. 72% of responders surveyed felt the lack of control in issues affecting their work life. This is a common finding among employed physicians. While many physicians are seeking safety within large, private hospital based and community health-based groups they end up sacrificing autonomy and independence. The physician’s ideal practice model may not be in line with your employer’s bottom line. My personal struggle with this was when I was employed by a large physician group in 2010 and received a ‘corrective action reprimand’ for not ordering enough ancillary tests. Though my diagnostic decision-making skills told me these tests were unnecessary as well as wasteful they were allowed given the diagnosis. My struggle with this wasteful testing quickly convinced me I need to chart my own path in healthcare and try and convince others to do the same.
#2. 71% of responders felt the clinical burden of the documentation of quality measure incentives was a leading cause of unhappiness. I have spoken with physicians who spend just as much time tracking down, reporting, or being hunted down by ‘the quality measure gestapo’ in their organization as they do with patients. Some physicians say they must perform this reporting after hours and on weekends to catch up. The amount of bonus money involved can be tens of thousands of dollars to large groups though the physician may get a small portion of this.
#3. 69% report emotional exhaustion within their professional as well as their private lives. When a physician has to see 20 – 25 patients/day, respond to 25 emails/day, review 10 – 15 lab/x-ray/consult reports per day, take after hours call, possible round on hospital patients after hours, and lastly throw in the quality documentation, it is easy to see how this exhaustion can take a toll on physicians. Can anyone say BURNOUT! A physician confided in me that she wants to make a change but all the opportunities she has come across are the same song and dance just a different day.
How does a physician take back their professional life and make a living doing it? Some physicians are starting their own concierge and DPC practices though most physicians do not have a patient population that can support those models.
No matter what your compensation model is whether it be DPC, fee for service or cash, the micropractice model allows you to keep your overhead low while providing healthcare that is by default, value driven. Because you can spend more time with your patients you are able to reduce unnecessary testing and referrals as well as reducing your stress level. Micropractice design allows one to practice cost effective medicine while providing yourself the quality lifestyle you have been looking for. Seeing 10 – 12 patients per day in the ‘Micro world‘ is equivalent to seeing your 20 – 25 per day in a traditional fee for service practice. Believe me this works. Before I started my current healthcare company which at this time will remain anonymous, I was very happy with my micropractice. My calling to take this idea and turn it into a national company was what brought me out of the practice of medicine and into the entrepreneurial side of healthcare. I will later reveal to the public who I am and what companies I have started but for now I will keep a low profile.
In closing, don’t give up on your ideal practice model. I promise you if one starts a micropractice and hangs in there they will be successful.