Perhaps the most sobering result from the 2017 Urology Times State of the Specialty survey is not the direction of the answers but the intensity and extent of physician dissatisfaction with the twin challenges of falling reimbursement and increasing overhead and regulation. Eighty-three percent say being a physician is less lucrative and more stressful than it used to be.
This experience is not surprising to anyone who has been in practice within the past few years, but it's clear that the challenges are common to all urologists across different age groups, different practice sizes, geographic regions, and practice styles. (The survey demographics are well representative of urologic experience.)
The questions this year were partially designed to assess how urologists are adapting to the new MACRA regulations. Not surprisingly, since a majority are pessimistic that the regulations will effectively cut health care costs, most urologists—54%—find them too complex to understand. Only a minority—26%—report they're ready to report for 2017, which will cause another 4% negative adjustment in 2019. And penalties for failing to comply increase each year.
Reflective of this experience, chafing under the burdens of electronic record data entry and frustrated over falling income despite working longer hours, many urologists are considering leaving practice. Physician burnout is widespread today, but the incidence among urologists is among the highest in every survey. This year's results underscore that fact, with an astonishing high number of respondents—72%—reporting they are already or are in danger of becoming burned out. The listed causes are familiar and unlikely to improve any time soon.
Not only is this individually distressful, but it has ominous impact on the overall urology work force. If nearly three-fourths of currently practicing urologists become fed up with practice and leave the field, how will we meet patient demand? Because this survey is reflective of physician experience across all fields, the results and conclusions must be made known to legislators and the system improved before too much is lost. A contented doctor means a satisfied patient and provides for a high-quality health care system.
I wish you all well for a successful 2018.
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