One-in-four PCPs in financial difficulty

The newest monthly Physician Wellbeing Index from online medical learning network QuantiaMD shows that 26 percent of primary care physicians report poor financial health.

According to QuantiaMD this trend – as well as a lack of incentives and other professional challenges – is resulting in many PCPs moving away from the practice of primary care, even as the Affordable Care Act places added emphasis on prevention and primary care.

"The financial struggles of a number of primary care physicians is disturbing news. Even more concerning is that health reform depends on having more primary care doctors playing an even more important role in healthcare, through new models such as the patient-centered medical home," said Richard Roberts, MD, president of the World Organization of Family Doctors and past president of the American Academy of Family Physicians, in a press release. "If financial challenges dissuade young physicians from entering careers in primary care or cause established primary care physicians to leave their practices, will there be enough primary care doctors for the influx of patients expected to enter the system?"

According to Mike Paskavitz, editor in chief of QuantiaMD, the monthly wellbeing survey was started by the company in January as a way to measure the overall wellbeing of doctors and it actively engages its community members in providing support to other members in these critical areas. It surveys doctors on what the company refers to as the four pillars of wellbeing: physical health, mental health, social health and financial health.

"Keeping physicians well is as important to the wider game of healthcare, as it is to keeping athletes healthy on a team," said Paskavitz. "Over the years we have heard more and more of the challenges of being a primary care physician. We could see it in the discussions on our system. We could see it through the way healthcare reform was playing out in compensation and reimbursement and we felt there was a level of organized support that was needed. So that is why we created the survey."

Key findings of the latest Physician Wellbeing Index of those physicians in financial difficulty include:

• 81 percent of physician practice owners report profits are down from last year;
• 43 percent of physician practice owners are having trouble covering their costs;
• 80 percent said a decrease in reimbursements is the top negative financial impact to their practices, while 71 percent also cited a rise in operating costs;
• 49 percent of employed primary care physicians have not had a salary increase in one to two years; and
• 18 percent of primary care physicians have experienced salary cuts.

"If you look at a trend…the individual private practice PCP does not feel viable," said Paskavitz. "Whether they go into the employ of a hospital or health system, or whether they join a larger group practice, that seems to be the way these doctors are gravitating as a result of these pressures."

The result of this is a diminishing motivation of PCPs to stay in the profession due to a number of years of little to no increases in reimbursement rates, as well as the financial burden placed on practices due to the need to implement new technologies, such as EMRs.

In Paskavitz's view, until these factors can be addressed, it will be increasingly difficult to make up for the shortage of primary care doctors, now estimated to be nearly 60,000 in within the next five years.