Seven physician leaders joined Becker's to discuss the biggest threats to physicians right now.
Editor's note: These responses were edited lightly for brevity and clarity.
Min Ho Cho, MD. Assistant Professor of Medicine at UMass Chan Medical School-Baystate (Springfield, Mass.): CMS and insurance reducing reimbursement for patient care and, in turn, hospital administration focusing on patients' length of stay rather than quality care. Additionally, lots of health problems stem from poor socioeconomic status. So without addressing patients' financial problems, their care will always be incomplete.
Marsha Haley, MD. Clinical Assistant Professor of Radiation Oncology at the University of Pittsburgh: Declining reimbursement is a huge issue that leads to many other problems. Physicians do not receive an inflationary reimbursement update — in fact, Medicare physician pay has declined over 20% over the past 10 years. With inflation resulting in rising overhead costs, it becomes more difficult for private practices to remain viable. These practices are then vulnerable to purchase by large, vertically integrated health systems. Physicians and their patients may then become victims of the corporate practice of medicine, which results in increased physician burnout and a decline in the quality of care.
Shalini Modi, MD. Service Chief of Cardiology at Henry Ford West Bloomfield (Mich.): Multiple threats are being faced by physicians. I firmly believe that anything that takes a physician away from their clinical work is a total waste of their core competence and a professional dissatisfaction. To name a few:
- Staffing challenges in the hospitals and clinics.
- Multiple lengthy "in-basket messages" sent by patients expecting a turnaround response of a few hours from their physicians for their various concerns. Accessibility of notes and lab reports coupled with the easy access to the internet generates quite a few questions, which all need an instant resolution per the customer. Some customers feel so empowered in their medical knowledge gained from the internet, friends and family that they constantly challenge an experienced physician who is actually on their side to make the best decisions for them.
- Prior authorizations for tests.
- Government interference.
Cary Passik, MD. Chief of Cardiothoracic Surgery at Good Samaritan Hospital (Suffern, N.Y.): I believe the biggest threat to physicians is the progressive loss of autonomy such that they are not making the decisions for the patients, but those decisions are made for reasons and by people for other than the patient's benefit. I think the administrative burdens of being a physician have become so onerous, where physicians are becoming a scribe of medical records, such that the patient-physician relationship is being progressively destroyed.
Sonia Ramamoorthy, MD. Chief of Colon and Rectal Surgery at UCSanDiego Health: Physician burnout and Medicare cuts.
Gregory Smith, MD. Associate Professor of Medicine at Northwestern Memorial Hospital (Chicago): The biggest threat physicians are facing right now is the growing imbalance of increased workload and increased work complexity relative to the compensation and workflow support available to enable provision of the clinical care so desperately needed by our patients and communities.
Kathleen Yaremchuk, MD. Otolaryngologist at Henry Ford Health (Detroit): The biggest threat facing physicians is the progressive decreases in CMS compensation to physicians for services rendered. This is causing a decrease in physicians in rural and urban areas, where Medicare and Medicaid is a large percentage of patient insurance. Access is poor and patient access to care decreases as well, which results in issues of healthcare equity.