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Patient Access to Care Falls As More Docs Look to Retire, Cut Hours

Almost half of doctors plan to modify their practice patterns in the next one to three years, and their top ways to alter their employment patterns could decrease patient access to care.

Patient access to care

Source: Thinkstock

By Jacqueline LaPointe

- Patient access to care could decrease as a greater number of physicians plan to cut down their hours, retire, or find a non-clinical job in 2018 compared to two years ago, a recent survey from the Physicians Foundation and Merritt Hawkins revealed.

The 2018 Survey of America’s Physicians found that almost one-half (45.8 percent) of over 8,700 responding doctors plan to change their physician practice patterns in one or more of nine different ways, ranging from retiring to merging or selling their practice.

“All of these options, with the possible exception of a practice merger, are likely to reduce overall physician FTEs [full-time equivalent] should physicians choose to pursue them,” the report stated.

Of the physicians planning a practice pattern modification in 2018, 22.3 percent of the doctors said they expect to cut back on hours in the next one to three years, representing the highest percentage recorded since the Physicians Foundation and Merritt Hawkins launched the biennial survey in 2012.

“It is difficult to quantify the number of FTEs this would remove from the workforce, but any such cutbacks are likely to have a negative effect on patient access at a time when many patients already have difficulty scheduling physician appointments,” the report elaborated.

Additionally, another 8.5 percent of physician respondents said they plan to switch to a part-time practice in the near future. The career move would allow them to work 20 hours or fewer a week.

Researchers project the switch to part-time clinical practice to reduce the physician workforce by about 34,000 FTEs assuming the doctors are currently in full-time practice.

Physicians already work less hours compared to six years ago. Doctors worked an average of 51.4 hours per week in 2018, the lowest number of hours recorded since the survey’s inception in 2012.

The number of hours has also consistently declined since that time. From 2016 to 2018 alone physicians reported a 2.4 percent reduction in the number of hours worked per week.

“The 2.4 percent decline in hours worked over the last two years may appear minor but it has a significant effect on the physician workforce, equating to the loss of 19,200 FTEs and to tens of millions of fewer patients seen per year, a contributing factor to protracted physician appointment wait times,” the report stated.

Retiring was the second most popular physician practice pattern change selected by respondents in the 2018 survey. About 17.4 percent of doctors planning to alter their practice patterns in the next one to three years expect to retire.

The percentage of doctors saying they plan to retire in the near future is also the highest number recorded by the Physicians Foundation and Merritt Hawkins. Just 14 percent of physicians in the 2016 survey said they plan to retire, 9.4 percent in the 2014 survey, and 13.3 percent in the 2012 survey.

If the physicians execute their plans to retire, the healthcare industry would be down approximately 136,000 physicians in the next three years given a total workforce of about 800,000 physicians in active patient care, researchers reported.

The industry should expect a significant portion of the doctors to carry out their plans to retire, the report added. Almost one-third (32 percent) of physicians are currently 60 years or older, which could suggest a wave of physician retirements.

The high percentage of retiring doctors could also exacerbate the physician shortage problem. Researchers stated that only about 85,000 doctors will complete their residency programs and enter the healthcare workforce in the next three years, creating about 51,000 job vacancies.

The Association of American Medical Colleges (AAMC) already projects the industry to be short of up to 121,300 physicians by 2030.

In addition to reducing hours and retiring, physicians who want to modify their practice patterns in the near future also plan to seek a non-clinical position in the next one to three years. The non-clinical jobs may include positions in research, quality control, or healthcare administration, as well as non-healthcare-related jobs.

“Whether working within healthcare or apart, these physicians would no longer be seeing patients. Should physicians leave clinical roles at this rate, an additional 96,000 physicians would be removed from the workforce,” the report stated.

Other physician practice pattern changes doctors plan to implement in the next three years included locum tenens employment (8.4 percent), concierge or direct pay (4.5 percent), hospital employment (4.3 percent), practice merger with another physician or group (2.8 percent), and practice sale to a hospital (2.2 percent).


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