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Young Docs Not Optimistic About Future
Young Docs Not Optimistic About Future
By Joyce Frieden, News Editor, MedPage Today
Published: April 12, 2012
Nearly 60% of physicians ages 40 and younger don't hold out much hope for American healthcare, according to results of an online survey released by the Physicians' Foundation.
Among the 500 respondents, nearly a third (31%) said they were "highly pessimistic" about the future of the U.S. healthcare system. Another 26% characterized themselves as "somewhat" pessimistic.
Only one in five see a brighter side -- just 4% said they were "highly optimistic," and 18% claimed to be "somewhat" optimistic.
About a third of those who were pessimistic (34%) specifically cited the "new healthcare law/regulations" as the reason. But that proportion would come closer to half if those who provided responses such as "system is a mess," "distrust of government," "government intervention," and "Medicare is a mess and will only get worse" are added in.
In fact, when asked specifically how the Affordable Care Act will impact their practice, 49% of all respondents -- those optimistic about the future of healthcare as well as the pessimists -- said the ACA will have a negative impact.
Nearly a quarter, though, said it would have a positive effect.
Even among the optimists, there was a decided sense of negativism -- 10% said they were optimistic because things couldn't get any worse.
In addition to concerns about the ACA, burdensome regulations and malpractice insurance premiums were also mentioned by respondents as reasons for pessimism, along with declining reimbursement and increasing costs.
"The level of pessimism among young doctors today is troubling and reinforces the notion that physicians need to be key participants in health policy discussions," said Lou Goodman, PhD, president of the Physicians' Foundation and CEO of the Texas Medical Association, in a press release.
Average age of the survey respondents was 37, half of them were in primary care, 35% were office-based specialists, and 15% were hospital-based specialists.
In all, 80% of respondents said they were "highly" or "somewhat" satisfied with their current practice arrangement -- 58% were employees of a group, with the highest percentage being in a group of two to six physicians.
When asked to name the factors that influenced their choice of current practice arrangements, nearly two-thirds (65%) cited income/cash flow, followed by employment security (53%), family life (46%), and other physicians (36%).
"Physicians who are just starting out must face the considerable challenge of massive student debt," Walker Ray, MD, vice president of the Physicians' Foundation and chair of the research committee, noted in the press release. "The Foundation has noted a growing sense among new doctors that they will never experience the autonomy and independence of previous generations. If you combine these factors with the overall uncertainty driven by healthcare reform, it is easy to appreciate the confusion and frustration of young practitioners."
The Physicians' Foundation is a nonprofit organization that focuses on physician practice trends and the impact of healthcare reform on physicians. The survey was conducted in December 2011 by Medical Market Research.
http://tinyurl.com/8xc3a8h
By Joyce Frieden, News Editor, MedPage Today
Published: April 12, 2012
Nearly 60% of physicians ages 40 and younger don't hold out much hope for American healthcare, according to results of an online survey released by the Physicians' Foundation.
Among the 500 respondents, nearly a third (31%) said they were "highly pessimistic" about the future of the U.S. healthcare system. Another 26% characterized themselves as "somewhat" pessimistic.
Only one in five see a brighter side -- just 4% said they were "highly optimistic," and 18% claimed to be "somewhat" optimistic.
About a third of those who were pessimistic (34%) specifically cited the "new healthcare law/regulations" as the reason. But that proportion would come closer to half if those who provided responses such as "system is a mess," "distrust of government," "government intervention," and "Medicare is a mess and will only get worse" are added in.
In fact, when asked specifically how the Affordable Care Act will impact their practice, 49% of all respondents -- those optimistic about the future of healthcare as well as the pessimists -- said the ACA will have a negative impact.
Nearly a quarter, though, said it would have a positive effect.
Even among the optimists, there was a decided sense of negativism -- 10% said they were optimistic because things couldn't get any worse.
In addition to concerns about the ACA, burdensome regulations and malpractice insurance premiums were also mentioned by respondents as reasons for pessimism, along with declining reimbursement and increasing costs.
"The level of pessimism among young doctors today is troubling and reinforces the notion that physicians need to be key participants in health policy discussions," said Lou Goodman, PhD, president of the Physicians' Foundation and CEO of the Texas Medical Association, in a press release.
Average age of the survey respondents was 37, half of them were in primary care, 35% were office-based specialists, and 15% were hospital-based specialists.
In all, 80% of respondents said they were "highly" or "somewhat" satisfied with their current practice arrangement -- 58% were employees of a group, with the highest percentage being in a group of two to six physicians.
When asked to name the factors that influenced their choice of current practice arrangements, nearly two-thirds (65%) cited income/cash flow, followed by employment security (53%), family life (46%), and other physicians (36%).
"Physicians who are just starting out must face the considerable challenge of massive student debt," Walker Ray, MD, vice president of the Physicians' Foundation and chair of the research committee, noted in the press release. "The Foundation has noted a growing sense among new doctors that they will never experience the autonomy and independence of previous generations. If you combine these factors with the overall uncertainty driven by healthcare reform, it is easy to appreciate the confusion and frustration of young practitioners."
The Physicians' Foundation is a nonprofit organization that focuses on physician practice trends and the impact of healthcare reform on physicians. The survey was conducted in December 2011 by Medical Market Research.
http://tinyurl.com/8xc3a8h
Go to the doctor and pay out of pocket say, for a chiropractor because you hurt your back. Tell em you dont have insurance and they cut a deal with you to pay a certain amount. I know someone who did this. 145.00 for the week.
Now, say you got insurance! You will get that same treatment for 5 times the amount of money because your insurance is paying for it.
You go to your primary care doctor for a cold and he will treat you for the cold, tell him your shoulder hurts and he will exray it and send you to a specialist that does shoulders where the specialist will do another xray and probably stick you in pt where they can milk some more money and if that doesnt work, they will do corizone injections for awhile and if that doesnt work then they will talk sx. Why? Because in order to get the shoulder repaired you got this long list of stuff the doctor has to try before he can fix the shoulder (per insurance guidelines). By the time you get to fixin the shoulder you have spent a small fortune already.
Just one example of what is wrong with our healthcare and why it is so high.
There will always be doctors who specialize to make money. Not too many because they actually care about the person tho I dont think.
Now, say you got insurance! You will get that same treatment for 5 times the amount of money because your insurance is paying for it.
You go to your primary care doctor for a cold and he will treat you for the cold, tell him your shoulder hurts and he will exray it and send you to a specialist that does shoulders where the specialist will do another xray and probably stick you in pt where they can milk some more money and if that doesnt work, they will do corizone injections for awhile and if that doesnt work then they will talk sx. Why? Because in order to get the shoulder repaired you got this long list of stuff the doctor has to try before he can fix the shoulder (per insurance guidelines). By the time you get to fixin the shoulder you have spent a small fortune already.
Just one example of what is wrong with our healthcare and why it is so high.
There will always be doctors who specialize to make money. Not too many because they actually care about the person tho I dont think.
Yes, it is quite rare for a malpractice case to go to trial and to receive payment in a settlement also is a pretty low percentage of cases. When you file a law suit such as this, you don't pay anything. However, the doctors must have representation. So, on their end, is this paid for by their insurance/lawyer provided in that way?
Obstetrics is one specialty that is sited as having incredible requirements for insurance coverage and it has affected the number of med students that pursue this specialty. Amount of insurance needed for one specialty verses another could help dictate where new doctors want to go and specialize in.
If you've ever been in a situation in which great wrong was done to a loved one of yours and a lawyer pleads your case whether for any financial pay out or principle, you won't think of that lawyer as a bad guy. They'll be your hero.
Obstetrics is one specialty that is sited as having incredible requirements for insurance coverage and it has affected the number of med students that pursue this specialty. Amount of insurance needed for one specialty verses another could help dictate where new doctors want to go and specialize in.
If you've ever been in a situation in which great wrong was done to a loved one of yours and a lawyer pleads your case whether for any financial pay out or principle, you won't think of that lawyer as a bad guy. They'll be your hero.
Yes I agree with what people said. I think that hospital closings which have not occured to this extent until recently are another concern and this article explains at least some of the reasons behind it:
http://www.msnbc.msn.com/id/28394340/ns/health-health_care/t/bad-debt-triggers-hospital-closings-around-us/
This has a negative effect on both doctors and patients. In the area I live there have been about 5 hospitals that closed (and many more in other parts of N.Y.C.) and because of this the quality of care has declined as well as an increase in the responsibilites and obligations of staff that work there to the point where they cannot properly assist people.
http://www.msnbc.msn.com/id/28394340/ns/health-health_care/t/bad-debt-triggers-hospital-closings-around-us/
This has a negative effect on both doctors and patients. In the area I live there have been about 5 hospitals that closed (and many more in other parts of N.Y.C.) and because of this the quality of care has declined as well as an increase in the responsibilites and obligations of staff that work there to the point where they cannot properly assist people.
Blame the lawyers - that's easy.
Medical malpractice cases are not at all certain to make a profit.
In the majority of cases the costs of litigation (which can be quite substantial) are fronted by the lawyers and the only way they get that money back is to prevail at trial or settle. Take a look at the statistics on medical malpractice litigation - or lack thereof. It's really quite interesting.
Actually medical malpractice premiums play a very small part in the cost of healthcare in this country. I have seen credible estimates of 5%.
And guess what? The medical malpractice insurance companies' profits have been steadily increasing - they're at the top pf the Fortune 500 list. So, it would appear that the malpractice premiums are increasing a lot faster than the payouts for malpractice suits - frivolous and legitimate.
Thu Apr 12, 2012 at 09:30 AM PDT
Insurance Rate Regulation Saves Doctors $23 Million on Excessive Malpractice Premiums
"The California Department of Insurance has saved doctors and other medical providers $23 million in the last two months by reducing unjustified medical malpractice insurance premiums using the state’s prior approval rate regulation authority. California law prohibits excessive malpractice insurance premiums for doctors, but does not regulate health insurance premiums paid by patients...."
http://www.dailykos.com/story/2012/04/12/1082596/-Insurance-Rate-Regulation-Saves-Doctors-23-Million-on-Excessive-Malpractice-Premiums
I always hear about the doctors leaving town because they cannot afford their malpractice premiums. That may be leaving but the ones I have seen leaving are all driving a Mercedes, a Lexus or a BMW. They sure aren't leaving in U-Hauls. I don't resent anyone making money but these doctors don't look like they're struggling to me. Like I always ask - how much is enough?
Mike
Medical malpractice cases are not at all certain to make a profit.
In the majority of cases the costs of litigation (which can be quite substantial) are fronted by the lawyers and the only way they get that money back is to prevail at trial or settle. Take a look at the statistics on medical malpractice litigation - or lack thereof. It's really quite interesting.
Actually medical malpractice premiums play a very small part in the cost of healthcare in this country. I have seen credible estimates of 5%.
And guess what? The medical malpractice insurance companies' profits have been steadily increasing - they're at the top pf the Fortune 500 list. So, it would appear that the malpractice premiums are increasing a lot faster than the payouts for malpractice suits - frivolous and legitimate.
Thu Apr 12, 2012 at 09:30 AM PDT
Insurance Rate Regulation Saves Doctors $23 Million on Excessive Malpractice Premiums
"The California Department of Insurance has saved doctors and other medical providers $23 million in the last two months by reducing unjustified medical malpractice insurance premiums using the state’s prior approval rate regulation authority. California law prohibits excessive malpractice insurance premiums for doctors, but does not regulate health insurance premiums paid by patients...."
http://www.dailykos.com/story/2012/04/12/1082596/-Insurance-Rate-Regulation-Saves-Doctors-23-Million-on-Excessive-Malpractice-Premiums
I always hear about the doctors leaving town because they cannot afford their malpractice premiums. That may be leaving but the ones I have seen leaving are all driving a Mercedes, a Lexus or a BMW. They sure aren't leaving in U-Hauls. I don't resent anyone making money but these doctors don't look like they're struggling to me. Like I always ask - how much is enough?
Mike
That always seems like a good idea until a doctor makes a mistake and kills your loved one. I'm just saying . . .(as a person that a doctor made a mistake and killed my loved one.)
Yes I would think ending malpractice insurance as a concept might help as it often sets up pointless lawsuits. I would put more of an emphasis on preventative means and ones that were encouraged rather than if not done would create legal charges. There are too many lawsuits in general that don't lead to anything except an income for lawyers and there should be tort reform to change this.
For the sake of the argument, I'll chime in. Our family doctor up and quit because of the amount of malpractice insurance he had to carry in this state. He changed some of the services he provided and the insurance cost grew even then. He moved to another state where his insurance is affordable... he is happy and that community gained one hell of a doctor who actually cares about who he cares for and cares about the quality of care he can provide. (In this community, that is a rarity.)
Debt gained from college is a no brainer. Assuming that the people who get into the medical field are slightly smarter than I am, they knew the amount of debt going in.... at least I would assume that would be the case. If that is the real problem, (the debt) we need to do something with our institutions of higher learning. I don't think it is a great idea to replace knowledgeable doctor professors with janitors. So where do you start? I am completely open to suggestions on this.
Debt gained from college is a no brainer. Assuming that the people who get into the medical field are slightly smarter than I am, they knew the amount of debt going in.... at least I would assume that would be the case. If that is the real problem, (the debt) we need to do something with our institutions of higher learning. I don't think it is a great idea to replace knowledgeable doctor professors with janitors. So where do you start? I am completely open to suggestions on this.
Years ago, when my first baby was born, healthcare was affordable. I didn't have insurance, and didn't need it. Neither did my parents.
The only health insurance I recall was for catastrophic events.
Then something called the HMOs came along. I recall our family doctor protesting, that to pay them, he'd have to raise his fees. Although is patients were willing to sign statements that they would never sue him, the law said he had to abide by these changes. This was in the 70s.
To me, insurance is like the Mafia protection racket, only it's legal. The have forced their way into the middle of health professionals and patients, and they are making the decisions.
I believe the solution is not Obamas plan but cutting the insurance companies out of the middle.
While in Thailand, I observed a multi-leveled system of health care.
There are fancy hospitals for those with the money. There are small local clinics, in all town, open at night, so working people can go to them.
And there are public low cost hospitals.
As my Thai dentist told me in shock when I told him I could not even get pre-transplant testing without insurance despite having money in the bank,
" Nobody is left to die in Thailand for lack of money."
At the risk of repeating myself, in order to care for people we need to stop making profit the number one value.
The only health insurance I recall was for catastrophic events.
Then something called the HMOs came along. I recall our family doctor protesting, that to pay them, he'd have to raise his fees. Although is patients were willing to sign statements that they would never sue him, the law said he had to abide by these changes. This was in the 70s.
To me, insurance is like the Mafia protection racket, only it's legal. The have forced their way into the middle of health professionals and patients, and they are making the decisions.
I believe the solution is not Obamas plan but cutting the insurance companies out of the middle.
While in Thailand, I observed a multi-leveled system of health care.
There are fancy hospitals for those with the money. There are small local clinics, in all town, open at night, so working people can go to them.
And there are public low cost hospitals.
As my Thai dentist told me in shock when I told him I could not even get pre-transplant testing without insurance despite having money in the bank,
" Nobody is left to die in Thailand for lack of money."
At the risk of repeating myself, in order to care for people we need to stop making profit the number one value.
Nope. Mines better...lol. Just kidding. You are so right though, and opinions completely depend on what your experience has been with the system you live under. The debate often comes up here as well. We have an upcoming Provincial election - election day is next week as a matter of fact. And no question the health care issue is part of the debate. It doesn't seem to be a popular idea to do away with Universal Health Care here, but everyone recognizes that changes need to be made. But just like in the US, the problem is here none of the parties can quite agree on what it is that should change. Makes sense I guess as healthcare is such an important issue to everyone..I sure do wish though that a consensus could be formed amongst our political parties so actual action could be taken and some of the problems solved. They seem more interested in arguing about it here then in actual dealing with it. That's the nature of politics I guess.
Well, flat out, our country is divided on this issue. No scare tactics, there is just a fundamental difference in wanting the government to provide our health care and a higher tax rate with some being for it and some being against it.
I do understand that you are satisfied and happy with your health care system and you have nothing bad to say about it. That will not be the case with all Canadians or others who have universal health care. So in America, you have many that are satisfied overall with our healthcare system and others that are not. It's a skewed view to say that because you are happy and I am happy that it means one system is better than the other.
And remember, we do have public healthcare for our countries poor.
I do understand that you are satisfied and happy with your health care system and you have nothing bad to say about it. That will not be the case with all Canadians or others who have universal health care. So in America, you have many that are satisfied overall with our healthcare system and others that are not. It's a skewed view to say that because you are happy and I am happy that it means one system is better than the other.
And remember, we do have public healthcare for our countries poor.
Well, as I said, I don't know the details of the plan in the US. I only know what ours is. And I have never known anyone to be denied anything medically necessary.
Don't take this the wrong way (I always worry about being offensive..lol), but I cannot help but think that the Insurance Companies are in "bed" with many politicians, and that they are doing a pretty good job of scaring people. The things I hear brought up that will or might happen if this continues are just not the reality of the situation here. Other countries, I don't know. But not here.
Don't take this the wrong way (I always worry about being offensive..lol), but I cannot help but think that the Insurance Companies are in "bed" with many politicians, and that they are doing a pretty good job of scaring people. The things I hear brought up that will or might happen if this continues are just not the reality of the situation here. Other countries, I don't know. But not here.
The American Medical Association is opposed as a group to a public health care system. They have their reasons I guess. But if this fundamental group in our country opposes public health care, this won't be a selling point for newbies considering that line of work.
If our government gets involved, doctors will be told what to do. Count on it.
I don't think our system is perfect now but many just flat out do not want the government to have a hand in their medical care---- whether providing the care or receiving it.
And I still contend that there are limitations to care given with universal health care that you aren't even aware of.
I don't think our system is perfect now but many just flat out do not want the government to have a hand in their medical care---- whether providing the care or receiving it.
And I still contend that there are limitations to care given with universal health care that you aren't even aware of.
But my friend, that is part of my point. I don't know much about how the Universal Health Care Plan is drawn up in the US, but if it's anything like ours, they really aren't capped. I think the confusion comes from folks seeing the gov't acting as an Insurance Company...setting fees, declining procedures, etc. But that's not how it works. It isn't the Insurance Company. My Dr tells me he likes it because they do not interfere (unless it's not an approved procedure - experimental or something). Now, of course it does have to be within reason otherwise people could bill any amount for anything. But trust me, the Dr.'s here are not hurting financially. I know in some countries that it is different..Cuba for example where Dr.'s make less then waiters, but that is a very different situation.
Rising University costs are impacting students, even with scholarships. And yes, your malpractice costs are huge compared to here as well. The other large cost your Dr.'s face that ours don't is administrative costs...billing, etc. and time going back and forth with the Insurance Companies for approvals, etc. We don't have that here as there is only one place to bill, and if the Dr. orders it and deems it necessary and it's an approved procedure, they don't say no. That makes admin costs far less.
Rising University costs are impacting students, even with scholarships. And yes, your malpractice costs are huge compared to here as well. The other large cost your Dr.'s face that ours don't is administrative costs...billing, etc. and time going back and forth with the Insurance Companies for approvals, etc. We don't have that here as there is only one place to bill, and if the Dr. orders it and deems it necessary and it's an approved procedure, they don't say no. That makes admin costs far less.
Oh okay. I'll go there. Debt is an issue, of course, and it has been for years. What the heck are all these increases for in college tuition??? Yeesh. And both my husband and I get quarerly calls from our respective universities fund raising.
And the other problem that many doctors complain about is the cost of carrying malpractice insurance.
Those are legitimate costs. But . . . if you are 'doctor material'---- many get a lot of scholarship money for undergrad. Bragging moment . . . my nephew got a perfect score on the ACT test. He has his pick of any university basically with scholarship money. The letters and calls are rolling in. He's got offers for big universities to have him test out of some basic courses and basically do pre med in three years-- well, I know of one of these. But Stanford is where he'll probably go. Point being, when you are of the caliber of intelligence that doctors are (I know there are some not so great one's too----- although they do have to pass tests that most couldn't) you have options. And you can take that brain into another field if you arn't going to get paid on the other end. And medicine needs big brains.
Just talking out loud here . . .
and anything that might cap income or put on new restraints to the field of medicine would make it less desirable to incur debt.
And the other problem that many doctors complain about is the cost of carrying malpractice insurance.
Those are legitimate costs. But . . . if you are 'doctor material'---- many get a lot of scholarship money for undergrad. Bragging moment . . . my nephew got a perfect score on the ACT test. He has his pick of any university basically with scholarship money. The letters and calls are rolling in. He's got offers for big universities to have him test out of some basic courses and basically do pre med in three years-- well, I know of one of these. But Stanford is where he'll probably go. Point being, when you are of the caliber of intelligence that doctors are (I know there are some not so great one's too----- although they do have to pass tests that most couldn't) you have options. And you can take that brain into another field if you arn't going to get paid on the other end. And medicine needs big brains.
Just talking out loud here . . .
and anything that might cap income or put on new restraints to the field of medicine would make it less desirable to incur debt.
And I could never see you as snippy adgal.
Debt load is an age old problem and people will be less likely to incur the debt if they don't make the huge dollars on the other end.
Ok, reread my post and it comes across rather snippy. You know I don't mean it that way! Just feel like Universal Health Care gets blamed for everyting!! But love you both!!
Umm...just something to point out on this. It seems to me that the biggest concern students have in terms of going into medicine is the student debt load they will carry. So to me, the answer lies in making college/university and med school more affordable..no? You all worry so much about Universal Health Care causing this, but in all honesty, our Dr.'s here are driving Mercedes just as the ones in the US do. It's not an issue. The problem is more the increased cost of school. And gotta be honest...my gp has practiced in the US and says it's more frustrating getting denied by the Insurance Companies..happens a lot. Sorry, just need to point out another possibility.
Well, I guess we'll always pay better is the assumption. But I think a listing of only foreign doctorsto choose from is actually a decrease in quality. Not meant to be offensive but I do like to understand what a doctor is saying as he is diagnosing me. Oh, they'll be doctors . . . but quality control is something I worry a bit about.
I wouldn't worry about fewer people going into medicine. Over half the specialists in the Midland-Odessa Yellow Pages have been South Asian surnamed for years. The marketplace abhors a vacuum. As long as we can pay more than other countries, we'll attract doctors. Lahore and Mumbai's loss is our gain.
I've seen 3 different doctors this year; none of them has had anything good to say about the ACA.
I do think you'll find fewer people going into medicine if the new healthcare law stands . . . so then things will be done to encourage it and then the quality of doctors will go down. Right now, most meet a standard that your average citizen could not meet academically.
I wish there was a way to have healthcare provided for more citizens without government intervention. I dream big.
I wish there was a way to have healthcare provided for more citizens without government intervention. I dream big.
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