Seven out of 10 physicians would not recommend their profession to their children or other family members, and more than half are thinking about retiring within the next 5 years, including one-third of those under the age of 50, according to a new national survey by The Doctors Company, a physician-owned medical malpractice insurer.

The survey of more than 3400 US physicians uncovered a "complex picture" of the attitudes of physicians nationwide toward the important issues facing the industry, with physicians reporting feeling disenchanted with the practice of medicine, the authors note in their report.

While the rate of change within practice models may have slowed in recent years, many physicians view the adoption of electronic health records (EHRs) and new reimbursement models as compromising the traditional doctor-patient relationship and the ability to provide quality patient care, the authors say.

Yet the survey also shows that physicians have not wavered in their advocacy for preserving the doctor-patient relationship and providing high-quality care.

Among the key findings from the Future of Healthcare survey:

* More than half of physicians (54%) plan to retire within the next 5 years because of pressure from declining reimbursement, increased administrative burden, and industry consolidation. The average age of men who took the survey was 62; for women, it was 55. Male physicians are more likely to retire than female physicians. Women are more likely to report that they are primary care physicians (PCPs) and men are much more likely to report being surgical specialists, so the burdens leading doctors to retire may be felt less on the PCP level, the authors say.

* More than half of physicians (54%) believe EHRs have had a negative impact on physician-patient relationships. "Doctors are concerned that EHRs are burdensome and distracting during patient interaction. One doctor suggested that the software causes major frustration to patients and physicians alike," the authors report.

* Nearly two-thirds (61%) of physicians believe EHRs are having a negative impact on efficiency and productivity. "Many comments suggest that doctors are frustrated with the functionality, reliability, and lack of interoperability within their EHRs," the authors note.

* More than 40% of doctors think value-based care will have a negative impact on the physician-patient relationship. "Many doctors worry that pay-for-performance reimbursement doesn’t take into account the nuances of the doctor-patient relationship and puts a focus on population-level data instead of individual outcomes," the authors say. Along this same line, 63% of the physicians surveyed said they believe value-based care and reimbursement will have a negative impact on their earnings.

* Almost two-thirds (62%) of doctors say they don't plan to change practice models, perhaps indicating that the pace of practice change seen in recent years may have run its course, the authors say.

* Three quarters (75%) of solo practitioners plan to stay independent. "Private practices are increasingly being acquired by health systems that want to better control the continuum of care, and some medical groups are merging to create larger practices to drive efficiency, cost savings, and better technology," the authors note. "Nonetheless, three quarters of the solo practitioners who took this survey told us they don't expect to be a part of that industry shift, but rather expect to remain independent. While many are staying put in their current practice model, physicians expressed concern about how industry changes will impact the future of individual and small group practices."

* Physicians have mixed views on accountable care organizations, with 43% saying they do not plan to participate and 57% saying they plan to participate, are undecided, or need more information.

* Physicians also have mixed feelings about clinically integrated networks (CINs): 38% do not plan to participate in a CIN and 37% are either undecided or need more information about participating in a CIN.

* Physicians are also split on independent physician associations: 30% plan to participate, 36% do not plan to participate, and 34% are either undecided or need more information.

* More than half (56%) of physicians don't plan to participate in patient-centered medical homes, 15% plan to participate, and 29% are undecided or need more information.

The survey included physicians in a range of medical specialties from 49 states and the District of Columbia who are insured by The Doctors Company.

The report was created in partnership with Modern Healthcare Custom Media and is available online.

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