From declining reimbursements to burnout, physician leaders joined Becker's to discuss the biggest threats to physicians.
Question: What is the biggest threat to physicians right now?
Editor's note: Responses were edited lightly for brevity and clarity.
Timothy Babineau, MD. Principal at ECG Management Consultants: Physician burnout is at an historic high with no clear end or solution in sight. Unless concerted, coordinated and nationally organized efforts begin to tackle this problem in a meaningful way, we will continue to see early retirements and continued erosion of our physician workforce — to the great detriment of American healthcare.
Thomas Castillo, DO. Ophthalmologist in Beaver Dam, Wis.: The biggest threat to physicians right now is the over-regulation of healthcare by governmental agencies and insurance companies. This is made even worse when these regulations create situations where the regulations of one agency oppose the regulations of another agency.
Joel Cleary, MD. Orthopedic Surgeon at Memphis Veterans Affairs Medical Center (Grangeville, Idaho): Themselves. … When the organization appears to be more important than the historical mission, the organization has become dysfunctional. And their greed. The American Academy of Orthopedic Surgeons is a good example. I find it amazing that the starting salary for an ortho surgeon is less than $500,000 a year. They gave up autonomy to insurance companies, politicians and bureaucrats for the big bucks.
Divya Joshi, MD. Pediatrician in Lawrenceville, Ga.: Biggest threat to physicians: burnout from increasing administrative demands and decreasing joy at work due to decreased interaction time with patients.
David Farkas, MD. Emergency Room Physician in Park City, Utah: I think the biggest threat is loss of trust in physicians. Especially after the pandemic, people were receiving conflicting information and getting medical information from various sources. A general misunderstanding of medicine and science in general is very concerning.
Laura Lowenstein. Healthcare Attorney and President of oNet Systems: Healthcare consolidation and regulatory capture. These are two forces squeezing independent providers and practices from both sides. Healthcare consolidation, especially in the hands of a few large national insurers (or related subsidiaries) has created narrower networks by design with less patient choice and satisfaction. As we create siloed health systems, we destroy the free market and allow large corporations to restructure how healthcare spend is allocated. Healthcare dollars are increasingly diverted to the third-party administrator profit centers, as opposed to being spent directly on patient care. When you couple this system with regulatory capture that results in new regulations and laws that do not take account of downstream impacts that cripple independent practices, the NSA being a recent clear example, you end up with a healthcare model that singularly serves the shareholders of large healthcare companies at the expense of a functioning healthcare system with patient care and the provider-patient relationship at the center.
Trevin Mayabb, MD. Family Medicine Physician at Ferguson Medical Group (Sikeston, Mo.): I believe the biggest threat to physicians is burnout. To me, the continued pressures from documentation burden, reimbursement issues, addressing prior authorizations and generally having to spend time in the EHR instead of direct patient care is a challenge that providers continue to deal with. A provider can feel like they are getting more administrative work than bargained for during medical training.
Matt Mazurek, MD. Assistant Clinical Professor of Anesthesiology and Director of Quality and Safety at St. Raphael's Campus of Yale New Haven (Conn.) Hospital: Physician burnout remains very high post-pandemic, and research has identified a few main causes which continue to be unaddressed by most hospital systems. The top three are workplace inefficiencies and administrative burden, workload and less time with patients, and loss of autonomy. These issues are systemic, and placing the burden on physicians to correct the cause of burnout exacerbates the problem. Additionally, physicians working in short-staffed, stressed environments with high workloads are primed to become exhausted and burned out.
Dennis Quagliani. President and CEO of Healthcare Associates: Declining reimbursement in parallel to cost increases in labor, supplies, drugs, etc.
Mukesh Sharma, MD. Interventional Nephrologist at Sierra Nevada Specialty Care (Reno, Nev.): I believe the biggest threat is dwindling reimbursements in the face of escalating employee costs coupled with higher wages to retain employees to run practices and ASCs Most everyone other than physicians have had an increase in wages during the past few years and the cost of running a practice has increased a lot without a comparable increase in revenue. This has led to a decrease in net profit to many independent practices across the country that are staring at depleting reserves and struggling to stay afloat.
Thomas Terndrup, MD. Professor of Emergency Medicine at The Ohio State University Wexner Medical Center (Columbus): Loss of individual autonomy, respect by public and disharmony with patients over medical decision-making. Increasingly, physicians decide to constrain, stop or retire in large numbers.