In 2016 a survey of our country’s physicians revealed that 50% of them would not recommend their career to a graduating college senior; and in 2018 a second survey reported that 70% of our country’s physicians would not recommend their career for today’s youth. So, what has gone wrong? What is making our physicians so dissatisfied with their once highly respected and highly rewarding careers?
In the “old” days a physician had a wonderful chance to know his or her patients. There were even examinations called “home visits”! When I was graduating from my own internship and residency in the late 1970s, 90+% of the young physicians went into a solo or group private practice. Today, when you examine graduating classes, 90+% of the physicians join large organizations where they become employees, clocking in and clocking out just like everyone else.
In the “old” days a physician usually treated an acute infection and enjoyed the satisfaction of a prompt 10-14 day cure. Today 86% of doctor visits are documented as assessments of chronic illnesses – where the treatment goal is disease management or symptom management, not a cure. Instead, there is just the goal of reducing the chronic symptoms and making the patient a little more comfortable. Now, which sounds more satisfying? A cure of an acute illness? Or management of long-term symptoms with partial success?
Nationwide, the average physician visit is 7 minutes long. That gives the doctor a chance for a diagnosis, a treatment with a prescription pill, and a quick good-bye. Actually, in the past year, there were 4 billion prescriptions, which equates to 12 prescriptions per patient. So, the physician – in today’s rushed visit – gets to prescribe multiple pills, not just one pill. And many people have believed that common saying: “One pill for every ill.” That is not true. And it is certainly not satisfying.
What is the resulting change in the daily work of the today’s average physician? The doctor has joined the factory line assembly. If all of the required work was going to focus solely on the patient, that might be a partial reprieve for the doctor. But today’s physician has to deal with financial-focused health care administrators, denial-prone insurance companies, and pill-pushing pharmaceutical representatives. Is there much satisfaction to be gained from those non-patient interactions? Not really.
So, what can today’s physicians embrace as their future? One political party wants to expand healthcare toward a Medicare scope, which would result in lower levels of reimbursement, higher caseloads, and declining salaries for physicians. The other political party wants to increase competition – and increased competition often means working faster, not just working smarter, at least for the physician.
As today’s physicians stare into the coming health care landscape, many of them have the same expressions as their patients. It is not a look of excitement or satisfaction. And they cannot divert their gaze, as there are problems along every sight line. An American diet, which is making people sicker. Insurance companies, which raise premium while still denying needed treatments. A medical supply industry, which keeps raising prices. A drug pharmaceutical conglomerate, which keeps pushing newer (and not necessarily more effective) drugs. And on and on …
Frankly, it is surprising that 30% of our physicians still recommend their career to our young college graduates. Maybe that is the question that you, as a patient, should ask your doctor? If your doctor still says ‘yes, I recommend this career highly’ … then you have come across a physician who is still dedicated – and still embracing – the ideal of caring for others. The ideal of turning disease into wellness. The ideal of giving each person a healthier platform, from which to enjoy life.
Good luck in finding that doctor …
And surviving our current system …