How Much Time Is Spent With Patients?
There's been little change since Medscape's 2012 Compensation Report in terms of how many hours physicians spend in direct patient care. About 30% of physicians spend between 30 and 40 hours a week, the same as in the 2012 survey. Also like last year, 22% of physicians spend less than 30 hours per week in direct patient care, probably because of working part-time.
The number of patient visits per week also has remained steady. Some 20% of physicians see between 25 and 49 patients per week, and an equal percentage see between 50 and 75 patients. One quarter of physicians see more than 100 patients per week, also about the same as the previous 2 years. Those seeing such a large volume of patients are probably working in a clinic or hospital setting.
Despite the pressure on physicians to see more patients daily, doctors still spend an adequate amount of time with each patient. The largest group of doctors (30%) spends between 13 and 16 minutes per patient, and 21% spend between 17 and 20 minutes with each patient. That's about the same as in Medscape's previous survey.
The Impact of Healthcare Reform
More physicians are jumping on the bandwagon for ACOs as a care-delivery and cost-containment method.
In last year's survey, only 8% of physicians were either in an ACO or planned to be in one within 1 year. However, in our 2013 report, 24% of respondents were either in an ACO or planned to be in one in the coming year.
"Many doctors took a wait-and-see approach because ACOs were so new," said Tommy Bohannon. "A year ago, we didn't even know if the Affordable Care Act would be repealed or overturned by the Supreme Court. So it took a while for ACOs to kick in. It's a big undertaking, requiring changes in doctors' attitudes, compensation models, and more."
Would You Choose Medicine Again?
Despite all the frustration at malpractice risks, electronic medical records, reporting requirements, and more, a majority (51%) of physicians would still choose medicine as a career if they could do it all over again. That's down slightly from 54% in 2012 and significantly less than the 69% who said they'd still choose medicine in 2011.
Only 42% of physicians would choose the same specialty -- about the same as in last year's survey, but down considerably from 61% the year before. Only 19% of physicians would choose the same practice setting, down from 23% in the 2012 report and 50% in the 2011 report.
Internists (66%), family physicians (62%), and pulmonologists (59%) are most likely to choose medicine as a career again. The least likely to choose medicine? Dermatologists (37%) and orthopedic surgeons (37%). That's ironic, because both are among the higher-paid specialties and dermatologists have the highest overall satisfaction rate.
"Even though incomes are rising, physicians are dissatisfied with the way medicine is going," said Tommy Bohannon. "They're under pressure to see more patients. Doctors complain of practicing assembly-line medicine. There's still uncertainty about health reform, giving up autonomy as employees, and loss of control over the clinical decisions they make. There's a deep-seated unrest that hasn't changed much."
"Doctors feel unhappy and underappreciated," said Judy Aburmishan. "They feel they aren't being paid appropriately for the effort they put in. It's only partly about money. It's more about respect and the way they see things going."