Physicians Under Attack


Your doctor is under attack. Not by you, the patient, but by the federal and insurance industry bureaucracy that has inundated doctors with paperwork and regulations that now demand more of their time than patient care.

Grace-Marie Turner and Carol Monaco, writing in Forbes, report the conclusions of a recent conference in Washington called “The Doctor-Patient Relationship.” They report, “Rather than providing the right care at the right time through shared medical decision-making, current health care policies are driving doctors and patients apart – draining time and resources from actual patient care and appropriate medical treatment.”

The needs of patients and doctors are getting lost in the system as payment and coverage policies for medical treatment become more complicated and more time-consuming. The result is doctor-burnout and patient frustrations and delayed treatments.

According to a study released by the American Association of Medical Colleges (AAMC) on March 14, 2017, the United States faces a physician shortage of 100,000 physicians by 2030. A growing population and an increasing number of physicians retiring early fuels this shortage. To combat this problem, the AAMC is requesting Congressional approval of an additional 3,000 residency positions over the next five years.

Why are physicians retiring early?

A recent American Medical Association study found that physicians spend twice as much time on clerical and data entry activities as they do with face-to-face time with their patients. This diminishes the effectiveness of patient care and leads to physician burnout. The AMA study found that “an average of 16.4 hours of physician and staff time each week is spent on completing prior authorization requirements to get patients the medicines, medical services or procedures they need.”

That time computes to 853 hours per year consumed by prior-authorization tasks. When this time is converted into dollars, the national time cost to practices of interactions with insurance plans is at least $23 Billion to $31 Billion each year.

Billions are also spent on complying with and reporting on quality measures that physicians say are not clinically relevant to patient care. A study by the Physicians Foundation found physician practices spend an average of 785 hours per physician and $15.5 Billion annually – an average cost of $40,069 per physician per year – reporting quality measures to Medicare, Medicaid, and private payers.

The impact on physicians’ mental and physical health is difficult to calculate – but the growing physician shortage compounded by early retirements is one measure.

The Hippocratic Oath, taken by most physicians for the last 2500 years, has recently been modified to reflect this trend. The World Medical Association recently made substantive changes designed to encourage focus on physicians’ mental health. Among other changes, the following has been added to the oath:

“I will attend to my own health, well-being, and abilities in order to provide care of the highest standard.”

In this modern healthcare reform debate, too much attention has been focused on providing healthcare insurance for more Americans at an affordable price. While this is important, it becomes a mute point when the number and quality of physicians available to provide treatment is declining at a rapid rate. We must preserve the high quality doctor-patient relationship and remember that health insurance without that is an exercise in futility.

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