Half of US doctors plan to retire, cut back, or seek non-clinical roles, according to a survey released by The Physicians Foundation and Merritt Hawkins, the physician search division of AMN Healthcare Services Inc. (NYSE: AHS).

According to the research, titled “2016 Survey of America’s Physicians: Practice Patterns and Perspectives,” 48% of physicians plan to cut back on hours, retire, take a non-clinical job, switch to “concierge” medicine, or take other steps limiting patient access to their practices. These practice pattern changes will reduce the physician workforce by tens of thousands of full-time-equivalents at the same time that a growing, aging and more widely insured population is increasing demand for doctors, according to the survey report.  

 “Many physicians are dissatisfied with the current state of the medical practice environment and they are opting out of traditional patient care roles,” said Walker Ray, M.D., president of The Physicians Foundation.  “The implications of evolving physician practice patterns for both patient access and the implementation of healthcare reform are profound.”

US physicians are changing their practice patterns in ways that will inhibit patient access to care, and they are largely disengaged from the mechanisms of healthcare reform such as value-based payments, accountable care organizations, and electronic health records. The majority of physicians surveyed, 54%, describe their morale as somewhat or very negative, 63% are pessimistic about the future of the medical profession, 49% always or often experience feelings of burn-out, and 49% would not recommend medicine as a career to their children, according to the survey.  

In response to regulatory burdens and other concerns, physicians are seeking alternatives to traditional, full-time private practice. The survey indicates that only 33% of physicians now identify as private practice owners, down from 49% in 2012, while 58% identify as employees, up from 44% in 2012.

The survey also asked physicians what they plan to do in the next three years. Responses compared to 2012 responses include:

• Continue as I am: 52.2%, up from 49.8% in 2012
• Cut back on hours: 21.4%, down from 22.0%
• Retire: 14.4%, up from 13.4%
• Switch to a cash/concierge practice: 8.8%, up from 6.8%
• Work locum tenens: 11.5% (2012 results not available)
• Cut back on patients seen: 7.5%, down from 9.6%
• Seek a non-clinical job within healthcare: 13.5%, up from 9.9%
• Seek employment with a hospital: 6.3%, up from 5.6%
• Work part time: 9.8%, up from 6.5%

“It’s not how many physicians there are that determines patient access to care, it’s how physicians choose to practice,” said Mark Smith, president of Merritt Hawkins. “By retiring, taking non-clinical roles, or cutting back in various ways, physicians are essentially voting with their feet and leaving the clinical workforce, to the detriment of patient access.”

Merritt Hawkins conducted the online survey for The Physicians Foundation from early April through mid-June 2016. It included responses from 17,236 physicians.

The Physicians Foundation is a nonprofit organization that seeks to advance the work of practicing physicians and improve the quality of healthcare for all Americans.