Where Expectations Meet Frustration

Physicians wonder: what has happened to focusing the practice of medicine on patient care?

By Pamela McKemmie | Remarks | September/October 2008 | Your Voice


“Give the practice of medicine back to the physician.”

“Get rid of lawyers, HMO, Managed Care Medicine and federal regulations.”

“Eliminate the hassles of getting reimbursed for an honest day’s work.”

“Malpractice issues—stop [the] practice of defensive medicine.”

“Free medicine of the stranglehold that the insurance industry has on reimbursement and practice styles.”

These are just a few of the more-than-2,000 open-ended comments we received in summer 2007 when we asked physicians what one thing they would change about practicing medicine if given the chance.

Out of almost 2,400 physicians responding to LocumTenens.com’s 2007 national survey, only 3 percent said they were not frustrated by nonclinical aspects of practicing medicine. The remaining respondents identified with a list of possible frustrations as follows:

  • Reimbursement issues – 29%
  • Administrative and business agendas interfere with clinical decisions – 22%
  • Medical liability issues – 19%
  • Lifestyle issues: Too much time at work – 15%
  • Federal regulations, policies, procedures – 8%

A comparison of our last two year’s physician survey results indicates an increasing level of frustration among physicians, since 6 percent of the more than 2,800 physicians responding to the same question in 2006 said they were not frustrated by nonclinical aspects of practicing medicine. That comparison also suggests that reimbursement is a growing concern, with 29 percent of 2007 respondents indicating reimbursement was what frustrated them most about practicing medicine today, compared to 22 percent of 2006 respondents.

[It was a close call, but Congress recently staved off a 10.6 percent reduction in payments to physicians who treat Medicare patients by overriding a presidential veto of legislation to delay the cut for 18 months.]

Contrast the increasing level of physician frustration with a sample of physicians’ survey responses regarding what they like most about practicing medicine:

“The people-to-people interaction and the thrill of the diagnosis and treatment thereof.”

“Getting to know the patients and finding an interesting disorder that would otherwise have been missed.”

“The challenge of solving problems for people. I can actually see that I am making a difference in the community.”

“I like to solve the puzzle and make people feel better. I enjoy the teaching part.”

“Being given the privilege of providing a highly skilled and rewarding service to those in need of medical attention.”

It’s evident that their frustration lies primarily with the “business” of practicing medicine, not with actual patient care.



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