PCPs Could use a Break

We’ve known for 20 years that US medical school graduates tended to enter disciplines having the highest earning potential. Since then, income disparity between specialists and primary care physicians has widened, and medical student debt has ballooned to an astounding median of $140,000 per graduating senior.

That’s why few were surprised when, last fall, a survey of graduating medical students revealed that only 2% of them planned to become PCPs. But low income was only one reason for their decision. Students were also turned off by what they perceived to be heavy workloads, continuous hassling with insurance companies and inadequate ancillary support.

Now, a study of the PCPs themselves has confirmed those perceptions. After performing a cross-sectional analysis of 422 family practitioners and general internists, Anita Varkey and her colleagues found that time pressure and a chaotic work environment are indeed serious problems on the front lines of health care.

More than half (53%) of the surveyed physicians reported time pressure during office visits, while 48% said their work pace was chaotic and 78% complained about a lack of control over their daily routine.

These factors were associated with low satisfaction, stress, burnout and a desire to leave practice. Fully 27% of the respondents claimed to be burned out and ready to pack it in.

Thankfully, the working conditions did not adversely affect the quality of care, as measured by medication and other errors tracked during a chart review.

The write-up is in the Annals of Internal Medicine.

In commenting on her team’s findings for BurrillReport, Varkey, an assistant professor of medicine at Chicago’s Stritch School of Medicine, said “healthcare reform strategies should consider the role that work environment plays in physician job satisfaction and quality of patient care.”

Glenn Laffel MD, PhD, Sr. VP Clinical Affairs