A medical staffing firm survey shows what’s really behind job dissatisfaction among physicians: stress, declining reimbursements, and loss of autonomy.
Six out of tenphysicians said they would quit if they could, a survey commissioned by the Physicians Foundation in 2012 revealed. Recently, healthcare staffing firm Jackson Healthcare, released the results of its third national survey of career satisfaction among physicians.
It sheds some light on the reasons why doctors are so dissatisfied:
1. High Stress
While no one in healthcare has an easy job, some roles are more stressful than others. For example, dissatisfied physicians are more likely than satisfied physicians to work in high-stress emergency medicine or critical care positions. Thirty-one percent of dissatisfied respondents in the JH survey said they regularly see patients in the emergency department.
Another source of stress is understaffing. More than a quarter of dissatisfied doctors surveyed said they don’t work with nurse practitioners or physician assistants, an indication they are overworked.
2. Dissatisfaction with the PPACA
While satisfied physicians are more likely to say they’ve acquired new patients as a result of the PPACA or to have had no shifts in their patient panels, almost a third of dissatisfied physicians say their business has suffered due to patients losing insurance coverage.
Sixty eight percent of those that are unhappy in their jobs say their income has fallen in the last year, which is almost twice the number of content physicians who say the same.
Additionally, 59% of dissatisfied physicians say they’ve had more issues with billing and collections from insurance companies in 2014 than they did in 2013, while only 44% of satisfied physicians said the same.
3. Shrinking Medicare Reimbursements
More than half of the physicians surveyed say Medicare billing was harder in 2014 than last year, and just under half said Medicaid billing was also harder. Half of the dissatisfied physicians said they would accept no new Medicaid patients. Almost half (44%) said they would discontinue seeing Medicare patients.
4. Career Path
According to the JH survey results, more than a quarter of dissatisfied physicians said they began working at a hospital because they could not afford to invest in their own medical practices. This group’s career path veered from its plan, and not all were happy about it.
On the other hand, more than a quarter say they have chosen to be employed physicians because of the lifestyle benefits employment offers.
Fostering A Two-Way Street
For those who once aspired to own their own practices, but instead found employment at a hospital or health system, integration can be tough, says Kenneth Hertz, FACMPE, a consultant at MGMA. He says this is especially true for doctors accustomed to working with smaller groups of people who share their values, vision for the practice, and thoughts on how to run a business.
“Those who became employed physicians immediately after training may not have the experience of self-determination from having been in private practice. If I… don’t have that experience or set of expectations, it’s easier to integrate into the hospital culture.”
But, whether or not a physician’s roots are in private practice, anyone can feel alienated by a faceless bureaucracy.
The best solution is to bring physicians into the fold, says Hertz. “Bring physicians into the process of making decisions. Let them know what’s going to happen before it happens.”
He urges human resources and management to be transparent with physicians about finances, management shift and other strategic issues.
In particular, Hertz says, it’s critical to ensure physicians feel valued. “Communication is critical, not just from the HR department, but from more senior levels.” Hertz advocates C-level execs dropping by physicians’ offices occasionally to make sure they feel included and recognized.
Finally, Hertz suggests facilitating real, honest communication with physicians. Ask what’s important to them, what barriers they are facing and create ongoing dialogues, he suggests. “If physicians are communicating with leadership… and leadership is not just communicating at physicians, but with physicians, which is a two-way street—physicians will respond to it,” says Hertz.
In turn, they are more likely to feel appreciated—which might lead to increased job satisfaction and physician retention.