Young Physicians Less Optimistic Due to Health Reform

Young physicians are losing out on the excitement and optimism that the first few years of medical practice typically holds.

That’s according to a new report released by The Physicians Foundation, which asked 500 physicians age 40 and younger how they feel about medical practice. Fifty-seven percent said they are pessimistic about the future of the U.S. healthcare system.

“My only surprise is that these physicians show the pessimism, and the disaffection, and the angst so soon in their careers,” pediatrician Walker Ray, vice president of The Physicians Foundation, told Physicians Practice. “When a physician finishes training …there’s an exhilaration, there’s a wonderful feeling of accomplishment that finally all of this work, and travail, and difficulty is behind you.”

Unfortunately, those positive feelings are quickly being hampered by, most notably, “new health legislation” and financial issues, according to the survey.

“These young doctors are feeling the same thing that we’re feeling,” said Ray, referring to his older colleagues. “There is an imperative now to be caring for more and more patients, to provide higher perceived quality at less cost, there’s increased reporting and tracking demands, and the regulatory environment is increasing as we speak. There’s also an environment of high potential liability, problematic reimbursement - and all this puts tremendous stress on the physician workforce.”

And while one might think that young physicians are more adaptable to change, and as a result, more accepting of healthcare reform than their older colleagues, that is not the case, according to the survey. Forty-nine percent of respondents said the Affordable Care Act will negatively influence their practices; only 23 percent said it would benefit them.

It’s important to acknowledge that physicians believe there are some good things about healthcare reform, such as expanded insurance coverage and restrictions on insurers regarding patient access to insurance, said Ray.

But the health law fails to address key issues such as the malpractice liability climate, the physician shortage, and the flawed Medicare Sustainable Growth Rate payment formula. “Physicians were looking for some relief from healthcare reform and we don’t feel we got it, we got more burdens,” he said.

The survey begs the question: Would young physicians just out of residency have made other choices if healthcare reform had been implemented before they went to medical school?

Many might have, according to a 2011 survey of final-year medical residents conducted by physician recruitment firm Merritt Hawkins. Twenty-nine percent of 300 respondents said if they had a chance to start over, they would not choose a career in medicine. In 2008, when final-year residents were asked that same question, that number was just 18 percent.

“Word is getting back downstream, which has to be worrisome for all of us who care about the workforce being adequate to meet the needs of population,” said Ray. “Not only are these young physicians in the [Physician Foundation] survey disaffected, but it’s getting down to the resident level.”

Overall, the survey results emphasize a need for change. More physicians need to be trained to combat the physician shortage, but until things change to make physician careers more appealing, it’s going to be hard to attract students to the medical field.

Unfortunately, the survey results aren’t just problematic for physicians, they are problematic for patients, said Ray. “There is a link between a robust and autonomous physician workforce and patient access to the highest quality of medical care, and I think that’s really what we should keep in mind.”

When you first entered medical practice were you optimistic about the future of healthcare? Do you think the perspective of young physicians has changed over the years?