Electronic Health Records


Survey: 81% of physicians feel over-extended by patient load

By Jennifer Bresnick

EHRs, meaningful use, and ICD-10 aren’t the only things stressing out physicians who are increasingly struggling to make ends meet while rising to the challenges of federal initiatives and changing patient demographics.  A survey of 20,000 providers conducted by The Physicians Foundation reveals that more than eight in ten physicians feels like they are over-extended or operating at full capacity when it comes to the number of patients they must see each day in order to keep revenue flowing.  More than forty percent are even considering taking drastic steps to decrease their workload, including turning patients away, reducing their hours, or even fleeing clinical work all together.

Physicians responding to the survey work an average of 53 hours a week and see 20 patients per day, but spend 20% of their time on non-clinical paperwork.  The vast majority, eight-five percent, have implemented EHR technology, but few physicians are satisfied with the outcome.  Only 24% think EHRs have improved their efficiency, while just 32% believe the technology has had a positive impact on patient care.  Forty-seven percent added that EHRs detract from positive interactions with patients, which has been highlighted in other studies as one of the key reasons physicians keep doing their jobs.

As the stressors continue to pile up, so do reasons to opt out of the practice of medicine.  Thirty-nine percent of providers plan to accelerate their retirement due to unsatisfactory changes in the healthcare system.  Half of physicians believe that ICD-10 will cause a severe disruption to their practice, and even more admit to having somewhat to very low levels of morale.  Older physicians and those who own their own practices were more likely to express sour attitudes towards the impact of healthcare reforms, while the growing number of employed physicians were slightly more sanguine about the future.

“The state of the physician workforce, and medicine in general, is experiencing a period of massive transition,” said Lou Goodman, PhD, president of The Physicians Foundation and CEO of the Texas Medical Association. “As such, the growing diversity of the physician workforce will reflect different perspectives and sentiments surrounding the state of medicine. While I am troubled that a majority of physicians are pessimistic about the state of medicine, I am heartened by the fact that 71 percent of physicians would still choose to be a physician if they had to do it over, while nearly 80 percent describe patient relationships as the most satisfying factor about practicing medicine.”

But physicians are becoming much choosier about the patients they take on board.  Despite 25% of providers believing the ACA is a positive development, thirty-eight percent of physicians refuse to see Medicaid patients or limit the number of Medicaid beneficiaries they take on board.  A quarter of providers feel the same way about Medicare patients.  Twenty-six percent of providers participate in an accountable care organization (ACO), yet just 13% believe that the pay-for-performance reimbursement structure will have a positive effect on quality and costs.

“These trends carry significant implications for patient access to care,” said Walker Ray, M.D., vice president of The Physicians Foundation and chair of its Research Committee. “With more physicians retiring and an increasing number of doctors, particularly younger physicians, planning to switch in whole or in part to concierge medicine, we could see a limiting effect on physician supply and, ultimately, on the ability of the US healthcare system to properly care for millions of new patients.”




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