While the majority of physicians (56.8%) worked in practices that were wholly owned by physicians in 2014, this majority decreased slightly from 60.1% in 2012. 7 Unfortunately, the response of medical leadership is to call for more physician testing in the form of Maintenance of Certification (MOC).Īs a result of the financial burden being placed on physicians, private practice physicians are essentially being forced into hospital employment and now, many private primary care physicians may be forced into Accountable Care Organizations (ACOs). 6 The focus of health care has shifted toward not only patient wellness but also patient satisfaction scores, despite the fact that high scores are correlated with worse outcomes and higher costs. The end result is that the average face-to-face clinic visit lasts about 12 minutes. In order to make ends meet, physicians have gradually had to increase the number of patients they see. Cost burden has been shifted to physicians to collect co-payments and co-insurance, maintain EMRs, take care of uninsured and under-insured, and provide ancillary staff for the EMRs and billing operations. Health care reimbursement from Medicare has decreased every year when adjusted for inflation. 5 This amounts to an earning wage of only $18 per hour. The average medical student graduates with $183,000 of debt, 4 and an average resident earns a salary of only $56,500 for over 60 hours of work per week. Physicians have seen declining reimbursement and increased expenses. 3 Physicians are leaving clinical practice to work as hospital administrators, or for health insurance companies, hedge funds or investment firms. In 2014, health care had more students in MIT’s executive MBA program than any other industry, accounting for about one in five members, or 20 percent, of the class of 2014. Physician MBA programs are flourishing more than 50% of medical schools offer a joint MD/MBA degree program. Medical students often select high-paying specialties with the goal of early retirement. Physicians are generally unhappy and many desire to leave the practice of medicine. Some depressed physicians also have substance abuse problems, another major risk factor for suicide. Doctors worry that if they admit to a mental health problem, they could lose respect, referrals, income and even their licenses. Female physicians have twice the rate of depression and 2.3 times the rate of suicide compared with the general population of women. While the rate of depression over a lifetime is basically the same for male physicians and the general population of men, about 12%, doctors’ suicide rate is 1.4 times higher. In contrast to the general population, where male suicides outnumber female suicides four to one, the suicide rate among male and female doctors is the same. Every year, between 300 and 400 physicians take their own lives, approximately one per day. Doctors have the highest rate of suicide of any profession.
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