FROM THE PRESIDENT by LEWIS HARGETT, MD
Job Satisfaction: Why Some Physicians Are Leaving the Profession
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Through the years, significant changes have taken place in the field of medicine. Some of the changes have had a negative impact on the medical profession, leading to physician burnout. Throughout this article, I will discuss reasons that have led to physicians’ burnout causing some to leave the medical profession. I will also discuss some potential solutions.
I have been satisfied with my career choice, and I have not experienced physician burnout. My busy medical practice and participation in organized medicine have led to my job satisfaction. Involvement with organized medicine has enabled me to understand and adapt to the changes and challenges to practice medicine in the U. S. However, many of my colleagues have discussed becoming increasingly dissatisfied with their career choice of medicine. This dissatisfaction has also affected many physicians through the U. S. I have been an active member involved in organized medicine for several health care organizations on all levels from committee chairs to president. Also, I have served on numerous hospital committees, attended local, state and national medical conferences as a delegate and as a member of the Board of Trustees at my medical school. These experiences have provided opportunities to engage in numerous discussions with hospital administrators, local, state and national legislators and colleagues regarding the changes in medicine. Often these interactions have led to discussions about physician burnout and job dissatisfaction.
Being a physician is more than a vocation. In my opinion, there is no other profession that requires education, time invested, dedication, technical skills, professional development, board certifications and recertifications that are required to do a job and then maintain those requirements throughout one’ s career. Physicians attend college, medical school and complete residency from three to seven years( depending on specialty). They are required to pass national boards to obtain a license to practice medicine. There are ongoing continuing medical education requirements as well as maintenance of specialty certification. Depending on the state, a medical license is required to be renewed every one or two years to practice medicine. These renewal applications have questions that can be potentially stigmatizing and discriminatory. All of those factors can contribute to physician burnout.
Another deterrent from entering or staying in the medical profession is the cost of medical education. Some medical students are graduating with substantial debt. This debt can be a significant burden causing financial stress and / or affect career choice( primary care vs. specialty). Also, debt can later affect medical students’ ability to obtain credit, purchase a home, build generational wealth, etc. It can take several years to pay off the debt contributing to financial stressors.
The changing health care landscape continues to affect practicing physicians. Corporations, for-profit health care companies, governments( state and national) politicians and the courts are having more input in how medicine is practiced. In some states, physicians can lose their medical license or face criminal prosecution due to new laws.
Many physicians work longer than the average 40-hour work week and call is often mandated. This takes away from personal or family time. Employed physicians can be mandated by their employers to see more patients( with shortened visits times) to increase productivity and profitability. Some physicians have become increasingly frustrated with the administrative burdens to include prior authorization, appeals, EMR and the threat of malpractice lawsuits that have led to defensive medicine. These factors can cause increased job stressors and the feeling of being less valued.
There continues to be a loss of autonomy among physicians as more have become employees vs. private practice. The rate at which hospital systems and private equity firms are acquiring physician practices continues to increase. The American Medical Association( AMA) has noted the steady decline in practice ownership. It was also noted that between 2012 and 2022, the number of physicians working in private practice fell by 13 percentage points from 60.1 %