Why Are Primary Docs Thinking About Leaving Medicine?

Why Are Primary Docs Thinking About Leaving Medicine?

50
SHARE

As you can imagine, I spend a lot of time with physicians. As a group, they sure do like to complain. Yet, medical school applications are strong, and residency spots are still competitive. So I take cries of “they’re all going to quit” with a grain of salt.

That said, I also like data. So it’s worth checking in every once in a while to see what physicians, as a group, are thinking. There’s a study in the Journal of Primary Care and Community Health that does just that:

The status of the primary care workforce is a major health policy concern. It is affected not only by the specialty choices of young physicians but also by decisions of physicians to leave their practices. This study examines factors that may contribute to such decisions. We analyzed data from a 2009 Commonwealth Fund mail survey of American physicians in internal medicine, family or general practice, or pediatrics to examine characteristics associated with their plans to retire or leave their practice for other reasons in the next 5 years.

What did they find? More than half of physicians age 50 and over had plans to leave their practice in the next 5 years, or weren’t sure about staying in practice. No physicians age 35-49 had plans to retire, but 20% weren’t sure they’d stay in practice. I take such numbers with a grain of salt, though. That’s partly because, as I said above, doctors like to complain. That’s also because saying what you are going to do in the future is not the same as what you will actually do. In case people hadn’t noticed, the job market isn’t too awesome out there. I think many physicians are delusional if they think they can just quit practicing medicine and find another lucrative job.

But I think that the reasons that primary care docs say they might quit are illuminating. Those reasons are likely the things that make them unhappy about practicing, and we can definitely learn from that.

Among the younger physicians, internists were more likely to talk about leaving than were pediatricians or family physicians. Having a lot of uninsured patients was associated with plans to leave, but having a high percentage of Medicare or Medicaid patients was not. Working long hours was associated with plans to leave, but seeing a high number of patients a week (>150) was not. And, surprising me not at all, the use of information technology had no impact on whether a younger physician might think about leaving the practice of medicine.

Older physicians were more likely to think about retiring. They are also more likely to think about leaving the practice of medicine if they had high numbers of uninsured, Medicare, or Medicaid patients. Those in solo or two-doc practices were more likely to think about leaving than those in larger practices.

Here’s the irony. For all the anecdotal stories of docs planning to quit because of outrage over the ACA, a number of provisions contained within it may make primary care docs, especially younger ones, less likely to jump ship. The ACA will reduce the number of uninsured, high numbers of which were associated with younger docs thinking about leaving. The formation of ACOs should also lead to fewer solo or small practices, which was associated with older docs thinking about leaving. Docs also like to see more patients, and no one thinks the ACA is going to lead to fewer patients in the health care system.

It’s entirely possible that the ACA might lead to fewer primary care physicians leaving medicine, not more. We will have to see. But the next time you read an op-ed by an doctor outraged by the ACA, threatening to quit, it’s worth remembering that he or she might not be representative of all of them.

Aaron E. Carroll, MD, MS is an associate professor of Pediatrics and the associate director of Children’s Health Services Research at Indiana University School of Medicine, as well as the director of the Center for Health Policy and Professionalism Research. Carroll’s work has been featured in The New York Times, USA Today, The Los Angeles Times, Newsweek, and many other national publications. He blogs at The Incidental Economist, where this post was originally published.

Leave a Reply

50 Comments on "Why Are Primary Docs Thinking About Leaving Medicine?"


Member
Jun 1, 2015

Thanks for your article. Its very informative and good.
Hello friends visit here for best health tips : http://healthtipsdoc.com/

Guest
Dec 1, 2014

Magnificent items from you, man. I’ve keep in mind your stuff prior to and you’re
just extremely magnificent. I actually like what
you have got here, really like what you’re stating and the way in which in which
you say it. You’re making it enjoyable and you continue to take care of to stay it smart.
I can not wait to learn far more from you. That is actually a tremendous site.

Guest

It’s difficult to find well-informed people about this
subject, however, you sound like you know what you’re talking about!
Thanks

Guest
Oct 19, 2014

I’m no longer sure where you are getting your information, but good topic.
I must spend some time studying more or figuring out more.

Thank you for great information I was looking for this info for
my mission.

Guest
Oct 18, 2014

Becaujse the admin of thiss web site is working, no uncertainty very shortly it will be renowned, due
to its feature contents.

My weblog omega vrt330 (Elias)

Guest

Hey superb blog! Does running a blog such as this
take a great deal of work? I have very little knowledge of computer programming however I
was hoping to start my own blog soon. Anyhow, if you have any recommendations or techniques for new blog owners please share.

I understand this is off subject however I just wanted to ask.
Appreciate it!

Guest
Oct 13, 2014

Thank you for the auspicious writeup. It in fact was once a enjoyment account it.
Glance complex to more delivered agreeable from you!
By the way, how could we communicate?

Guest
Oct 5, 2014

Have you ever thought about including a little bit more than just your articles?
I mean, what you say is valuable and all. But just imagine if you
added some great pictures or videos to give your posts more, “pop”!

Your content is excellent but with images and video clips, this site could certainly be one of
the best in its niche. Amazing blog!

Guest
Aug 16, 2014

I am genuinely thankful to the owner of this website who has shared this impressive
post at at this place.

Guest

Reivers (National Snap shots Generale; regista Level Rydell) Sulla foundation dell’ultimo romanzo di William Faulkner, Reivers racconta california storia (within flashback) di tre giovani gna hanno colpito california strada each and every scoprire california vita. Charlie McQueen interpreta Lucius gna colpisce california strada fool figlio delete leader piantagione ice l’afroamericano tuttofare (candidato all’Oscar Rupert Crosse) gna ripone. movies è stato sia us ufficio di critica ice di colpire within quanto guadagnato più di Eight dollars milioni di pound grazie alla enorme popolarità della stella McQueen. On una nota di lato triste, attore Rupert Crosse, gna è stato nominato arrive miglior attore non protagonista each and every movies ice gna years grandes amico di Port Nicholson, non poteva godersi suo successo ritrovata. Poco dopo è stato diagnosticato us cancro ai polmoni ice determinato arrive lui years di battere california malattia (lol continuato an important lavorare), cancro finalmente avuto california meglio su di lui. Age stato lanciato arrive partner di Nicholson nella Guardia Costiera over the past Information master of arts divenne troppo malato each and every lavorare impotence è morto all’età di Forty avanti della sua uscita.
Moncler Giù Gilet Donna http://www.buytop-online.eu/moncler/moncler-giugrave-gilet-donna-c-1.html

Guest

Hand Held Enthusiast
Christian LouboutinRolling Spikes Flat Patent Stone http://www.christian-louboutinncheapsales.co.uk/christian-louboutinrolling-spikes-flat-patent-stone-p-193.html

Guest
Jan 4, 2014

Ruben age Jane (Twentieth century Sibel; regista John p Yates) Una strana commedia drammatica su una giovane coppia (Dustin Hoffman, Mia Farrow) che si incontrano, dormono insieme age apprezzabili passare celui-ci resto delete motion picture your cercare di capire l’un l’altro fuori di decidere pueden sono fatti in every concentrate insieme. Chicago sceneggiatura delete motion picture è simple insieme interessante age originale age segue anticipated major gadget attraverso celui-ci pezzo alla sua conclusione. Celui-ci motion picture è uscito limitatamente mummy divenne simple successo grazie treasure di stato your caldo dei suoi anticipated attori principali (Hoffman è venuta fuori da marciapiede mentre Farrow è venuta fuori di Rosemary oil Toddler). I just critici sono stati divisi, mummy celui-ci motion picture è stato simple successo solido.
Zaini MCM stile http://www.mcmitalia.buytop4u.eu/mcm-zaini-mcm-stile-c-13_5.html

Guest
Jan 4, 2014

Portions of your Rounding about FanThe steak: This steak can also be known simply because sticks and also panels. Bones has been produced from cream, calcaneus, camphor fire wood, sandalwood, turtle devote, precious metals. There’re sometimes pierced by way of complex design, getting back together the entire archipelago mucking buff.
Peuterey Sale http://www.peuterey2sitoufficiale.com/

Guest
Guest
Jan 4, 2014

On the lookout for Richard Gary the gadget guy. Reiten quota di proprietà: esattamente Thirty-two.809 (contro 35,454 mila anni - anno) azioni per BMHC 3 years ago Proxies Declaration.
goyard borse http://www.goyardborse.buytop4u.eu/