You won’t be surprised that, in a recent survey of physicians, more than half (54%) rate their morale as somewhat or very negative. As I read through the survey highlights and delved into the numbers, the reason for all of this negativity became crystal clear: There is entirely too much change going on in medicine, not to mention politics, society and anything else you can point or shake a stick at—except maybe your dog.

Physicians are fatigued by the rapid rate of change and the relentless, oncoming waves of rule-making from CMS. Slightly less than 20% of the physicians surveyed said that they were familiar with the Medicare Access and CHIP Reauthorization Act[MACRA]—and their income depends on it. That it would come to this—that so many physicians would be too busy to even wonder how they would be paid next year—surprised me.

The survey, based on 17, 236 physician responses, shed a bit of light on that issue as well. Slightly less than half of all physicians (49%) reported often or always experiencing a feeling of burnout, more than a quarter (28.2%) reported being overextended and overworked and only 13.9% said they generally have all the time they need to provide the highest standards of care. As a result, more than half are looking to get out, in some fashion, either by retiring, taking a non-clinical job, switching to a cash-only concierge practice or working part-time, for instance.

Patients-per-day counts—and daily imaging study quotas—are on the rise and so is the average number of hours that physicians spend on paperwork—11.29 hours per week. Not surprisingly, regulatory/paperwork burden is the number one factor in job dissatisfaction, so said 73.8% of all physicians. Erosion of clinical autonomy (31.8%) and inefficient EHRs that lack interoperability (26.8%) were the number two and three factors in job dissatisfaction

That most physicians would find the time to read even those regulatory communiqués that are most pertinent to their line of work is unlikely.  I don’t even have time to read them, and sifting through information is all that I do—they just don’t stop coming.

That so many physicians resent the erosion of their clinical autonomy and are consumed by a feeling of powerlessness over their fate is reflected in their response to a different question: Slightly less than 60% thought they only had a small ability  to influence the health care sytem. Just 17.2% believed they could have a good or great deal of influence.

There is irony in the fact that physicians feel so powerless considering that they drive such a big piece of the healthcare economy. The report1 cites AMA data that pegs the economic output of all U.S. physicians at $1.6 trillion; each physician contributes $2.2 million per capita economic output supporting 14 jobs. According to Merritt Hawkins, which conducted the survey, physicians generate $1.56 million in annual revenue for the hospitals with which they are affiliated.

Fragmentation undoubtedly contributes to physicians’ unwillingness to own their power in today’s healthcare arena, but practices are getting larger, with 28% now practicing in groups of 101 or more, up from 12% in 2012. However, fewer physicians are practicing in groups that they own—just 33% reported owning their practices in 2016, down from 48.5% in 2012.

The survey indicates a very small improvement in physician morale with regard to their current situation, but a significant increase in negativity with respect to the future of medicine. I can’t help but wonder if the rise in the employed model is a factor in physicians’ growing pessimism about the future of medicine?

Is this you?

Are you the physician convinced that you have no influence, or are you the one rolling up their sleeves and attempting to have a say in their future? The antidote to low physician morale is high physician engagement.

First, though, you need to admit that that our healthcare system needs improvement. Yes, crown princes from the kingdom of Saudi Arabia and other fantastically wealthy people come to the United States for their healthcare, but our standings on World Health Organization basic population health measures are appalling. We can do better, but it is not going to happen if physicians—including radiologists—turn medicine over to well-meaning bureaucrats.

Engage now. Don’t wait.  

Editor’s Note: After nine years at this post, I am moving on to work in radiology practice communication. I wish Michael Walter the very best in his new position as editor of Radiology Business Journal. It has been a privilege to serve your information needs.