January 26, 2023
Physician happiness plummeted after the pandemic
A new report says that physician happiness dropped during the pandemic by 22%, while the number of doctors saying they were somewhat or very unhappy jumped 188%. The Medscape Physician Lifestyle and Happiness Report 2023 found that 60% of physicians said they were very or somewhat happy, a drop from 80% before the pandemic. Another 26% said they were unhappy, a jump from 9% before the pandemic. In terms of parenthood, 49% of women felt conflicted or very conflicted compared to 28% of men. As for marriage, just under 90% of male physicians and just over 75% of female physicians are married or cohabitating. Most (81%) physicians describe those relationships as good or very good. When it comes to vacation, 43% of physicians take three to four weeks a year; 28% take one to two weeks per year.
A look at how the physician workforce is changing
A new report from the Association of American Medical Colleges is shedding light on demographic changes in the physician workforce. AAMC data show that in 2021, about half (47%) of U.S. physicians were 55 or older, and female physicians accounted for 37.1% of U.S. physicians. A report in Becker’s Hospital Review said that percentages of women by specialty ranged from a high of 65% (pediatrics) to a low of 5.9% (orthopedic surgery). More than half (63.9%) of physicians identified as White, 20.6% identified as Asian, 6.9% identified as Hispanic and 5.7% identified as Black. A second report in Becker’s Hospital Review found that the three fastest growing specialties in 2021 were sports medicine (up 42.5%), pediatric anesthesiology (up 37.7%) and interventional cardiology (up 32.6%).
January 19, 2023
Groups owned by private equity have higher clinician turnover, more APPs
A new study found that medical groups purchased by private equity firms tend to not only have higher turnover in clinical staff, but big annual increases in the number of APPs working there. The study in Health Affairs looked at staffing levels in practices from three specialties: dermatology, GI and ophthalmology. Researchers calculated a “clinician-replacement ratio” by taking the number of clinicians who entered groups and dividing it by the number of clinicians who left. For the group as a whole and for practices in all three specialties, the ratio was significantly higher for groups that had been purchased by private equity firms. Researchers also found that groups owned by private equity firms hired significantly more APPs. The lead researcher told MedPage Today that the data raise questions about the longitudinal nature of care at practices owned by private equity firms.
The case for making referrals to docs you know from training
It turns out that patients give higher marks to physicians who are referred to them by a PCP who knows the specialist from training. A study in JAMA Internal Medicine found that when specialists had spent at least one year in training with the PCP, patients referred to that specialist gave the physician substantially better ratings. Patients in that situation said they received clearer explanations and more shared decision-making than patients who saw a specialist their PCP didn’t know. A MedPage Today article said the higher scores effectively moved the specialists from the 50th percentile to the 90th percentile in performance rankings. Researchers also found that specialists with a training link to referring PCPs were also more likely to prescribe medications and/or order imaging.
January 11, 2023
How will proposed rule on noncompetes affect physicians?
A proposed rule from the Federal Trade Commission that would ban most noncompetes has health care industry experts debating if the rule will be turned into law and how it will play out for physicians. A report in Fierce Healthcare quotes one health care attorney who says that because the rule falls under an act that bans unfair methods of competition, it will likely not apply to nonprofit organizations. As a result, nonprofit health care systems would be exempt from the rule. The Fierce Healthcare report also says that about 45% of PCPs have a noncompete in their contract. While the U.S. Chamber of Commerce has called the proposed rule “blatantly unlawful,” a number of states have already started to rein in noncompetes in their jurisdictions.
HHS rule on test results is causing communication problems for physicians
Medical groups are pushing back against an HHS rule requiring that patients get their test results and other health care information as quickly as possible, often via patient portals. The problem, they say, occurs when patients get the news before their physician has a chance to explain what the data or test results mean. A report in Politico says that the HHS implemented the rule in 2021 to promote data-sharing and patient access to data. The agency created an exception that allows physicians to not divulge information if it would harm the patient, but physicians say the exception is too narrow and leaves patients receiving life-altering news without being able to consult their physician. Patient advocates support the new rule, saying that getting bad news sooner allows patients to begin looking for resources like a clinical trial or second opinion sooner rather than later. Groups like the AMA say they’re asking for a delay of only a few days so doctors can deliver bad news themselves and not let patients try to interpret it on their own. The AMA also cites survey results showing that two-thirds of patients want their doctor to talk to them about “life-changing” results. The Politico report notes that a handful of states have passed laws giving physicians a little more time to review information before having to release it to patients.
January 4, 2023
ED docs, consumers want to stop investors from owning medical groups
Emergency medicine physicians and consumer advocates are joining forces to stop the corporate ownership of medical practices. A report from Kaiser Health News notes that more than 30 states already prohibit corporations that are not owned by physicians from owning medical practices. The article notes that corporations, however, have figured out ways to sidestep those bans by giving physicians legal ownership of those practices—but giving them no authority in day-to-day operations. Opponents of the trend say the worst offenders are private equity investors, which own huge staffing firms in emergency and hospital medicine. The advocacy group Take Medicine Back has petitioned the North Carolina Attorney General to examine corporate ownership of physician groups. The Attorney General in that state also holds a senior position at the National Association of Attorneys General and may be able to shed national attention on the group’s complaint. And a Milwaukee emergency medicine group is suing Envision for setting up ownership structures that allow company officials, not physicians, to retain “de facto ownership” of medical practices. The lawsuit is scheduled to begin in January of 2024. Skeptics, however, point out that with nearly 70% of physicians employed by hospitals and corporations, the fight against corporate medicine may be too late.
Unionization in health care not common, but offers some benefits
While unionization in health care remains low, collective bargaining brings heath care workers some benefits. A study of unionization in health care in JAMA Network found that about 13% of workers, most of them nonphysicians, engage in some form of collective bargaining. Researchers found that unionized health care workers earned about 9% more than their nonunion colleagues and were more likely to have retirement benefits (58% vs. 43%). Unionized health care workers were also more likely to have employer-based health care (22% vs. 16%) and work more hours per week. The study said that while the numbers of health care workers who belong to a union didn’t change much from 2009 to 2021, the first half of 2022 saw a 57% increase in petitions to form unions in health care.
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