The changes sweeping through the medical profession have strewn collateral damage widely among those who labor in the field.

Now, a study from the Physicians Foundation reports that even those at the top of the health care pyramid — doctors — are struggling with their chosen career path.

The foundation is a nonprofit that, among other objectives, has been following the effects of the Patient Protection and Affordable Care Act on physician groups.

In its 2016 survey of physicians, based upon more than 17,000 email responses from physicians to questions from foundation, uncovers an alarmingly high rate of unhappiness among these doctors with their work.

While a good part of this low morale can be traced to the ripple effects of the ACA — more paperwork, changing work environment, etc. — the health care reform alone isn’t responsible for the general disappointment many doctors feel.

Their world is shifting. They are less well compensated, forced to invest in and work with new technology, hard pressed to keep up with authorizations and mountains of insurer paperwork, and strapped for time to spend with the patients whose welfare rests at the heart of their mission.

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Findings from the study

The 84-page report is loaded with details from the collected data that illustrate in many ways how difficult the physician’s life has become. Among the key findings:

  • 54 percent say they experienced low morale around their work.

  • 63 percent say they viewed the profession’s future negatively to some degree.

  • 49 percent admit to feeling burnt out much of the time.

  • 49 percent would not recommend their career to their children.

  • 80 percent say they were at capacity or overextended and couldn’t see new patients.

  • 72 percent say administrative burdens such as third-party authorizations were undermining the quality of care they provide.

  • 14 percent say they have the time to provide the highest standards of care.

  • 48 percent are contemplating various ways to change the way they work to reduce patient access to their practice.

The survey asked respondents about industry trends as well as their personal feelings about work. Among the findings there:

  • 43 percent say they participate in insurance exchange market products.

  • 44 percent believe hospital employment of doctors is a positive trend.

  • 43 percent say their compensation is tied to quality or value metrics.

  • 33 percent identify themselves as practice owners or partners, compared to nearly 50 percent in 2012.

  • 17 percent say they were in solo practice, compared with 25 percent in 2012.

  • 20 percent say they belong to physician practice groups with more than 100 doctors, compared with 12 percent in 2012.

  • 27 percent say they either refuse to see Medicare patients or limit the number they see.

The report notes that “physicians are not uniform in their perspectives” and that younger physicians, female doctors, employed doctors, and PCs “are notably more positive about the current medical practice environment” than older males, specialists and practice owners.

At the same time, it says, “the majority of almost all types of physicians suffer from low morale and express doubts about the direction of the health care system.”

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Dan Cook

Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.