More doctors than ever in Massachusetts are unhappy with most areas of their practices, a trend that appears to reflect growing dissatisfaction among physicians across the nation, according to a new study co-sponsored by HHS' Agency for Healthcare Research and Quality.
The survey, conducted in conjunction with the Robert Wood Johnson Foundation, compared findings from 1986 and 1997 surveys of Bay State primary-care physicians.
By 1997, fewer than two-thirds of doctors surveyed were content with "most areas" of their practices, a decline of about 20% from 11 years ago. Blame was placed squarely on managed care.
"Many of these physicians began practicing decades ago in a system with virtually no oversight or restraint on spending," said Dana Gelb Safran of New England Medical Center, who was principal investigator for the project. "From their perspective, the changes in their professional life have been profound, and for the most part, unwelcome.
"If we had tracked physician satisfaction in other parts of the country with healthcare markets similar to Massachusetts' we would have expected similar findings."
The dissatisfied doctors were not unhappy with their own performance, however. More than 90% of respondents in both the 1987 and 1997 surveys said that they were satisfied with the quality of care that they were able to provide.
Unhappy doctors can wreak havoc on the healthcare industry. Gelb Safran pointed to numerous studies showing that dissatisfaction leads to increased physician turnover and a resulting decrease in the continuity of care for patients. That, in turn, leads to increased costs, Gelb Safran said.
A recent study by the California Medical Association supports her assertion. About half of the 2,300 respondents to the survey-unhappy with the medical profession and managed care-planned to quit, retire or leave California within the next three years. Officials with the California Association of Health Plans, however, suggested the survey was politically motivated and faulted it for its small size.
"The changes that have come to the medical profession over the past 10 to 15 years have put enormous pressure on physicians with regard to their productivity and performance," Gelb Safran said. "As the American healthcare system continues to evolve, the satisfaction of patients and healthcare professionals alike will need to be monitored to assure the future quality of healthcare services."