Medical Economics magazine, in its July/August issue, published their “96th Physician Report” on the financial health of physician practices. It asks questions such as “Is the financial state of your practice better, worse, or about the same?” “What do you consider to be the biggest challenges facing physicians right now?” AND “What would you change about how medicine is practiced in the United States?”
These, and many other questions, (and their answers) occupy the thoughts of physicians as they struggle financially and administratively to remain viable and relevant in the world of health care. As I mentioned before, physicians are gradually losing their autonomy, their ability to earn a good living, and their status as the dominant providers of medical care. “Too many non-physicians are being allowed to practice medicine…..and PA’s and NP’s are seen as ‘just as good as doctors.” This is the prevailing opinion among primary care providers, as their role slowly declines in importance to patients.
The survey has 8 pages of data so I will share just some of the results; results that I think would interest most non-physicians. I will offer opinions on each of the questions after the results are reported.
PRACTICE FINANCES:
IS THE FINANCIAL STATE OF YOUR PRACTICE….? (Compared to a year ago)
Better 13%
Worse 35%
About the same 52%
Opinion: I’m surprised there are 13% who say finances are better. My guess would be that
5% or less is more realistic. And 35%, one-third, say finances are worse. I would say that
number should be higher.
MAIN REASONS FINANCES ARE BETTER:
Seeing more patients 32%
Adding ancillary services 32%
Receiving performance incentives 24%
MAIN REASONS FINANCES ARE WORSE:
Higher overhead (salaries, rent, utilities, supplies, etc.) 87%!!
Lower Reimbursement 82% (should be 100%)
More time spent on uncompensated tasks (prior auths, precerts) 69%
Opinion: These are practice/business killers. Low income plus high costs equal insolvency.
DID YOU EARN INCOME FROM A SOURCE OUTSIDE YOUR PRACTICE?
Yes 32% No 68%
Opinion: That’s a full one-third of physicians who supplement their income through outside
work. Forty nine percent earned an extra amount up to $70,000 a year. Thirty years ago
that percentage would have been less than 5%.
THE BIGGEST CHALLENGE(S) FACING PHYSICIANS NOW:
Inadequate reimbursement 82%
Burden of paperwork/ quality metrics 78%
Third party interference—prior authorizations, drug formulary compliance 75%
Non-physician providers gaining practice and prescribing independence 55%
Prior Authorization burdens: Better 1%, Worse 69%, About the same 31%
Opinion: These issues will never get better, only worse. They will never go away.
PRIOR AUTHORIZATIONS:
Prior authorizations are obtained by the doctor’s office from insurance companies and
verify the company is approving a test/procedure the doctor orders and will pay for that
test/procedure. Without prior authorization, the test will not be done.
ARE PRIOR AUTHORIZATION BURDENS GETTING BETTER OR WORSE?
Better 1%
Worse 69%
About the same 31%
THIS IS THE MOST TIME CONSUMING AND PROFESSIONALLY DEMEANING PROCESS A PHYSICIAN AND HIS STAFF ARE FORCED TO DO!!
MALPRACTICE:
DO YOU WORRY ABOUT BEING SUED?
YES 63%
NO 38%
DID YOUR MALPRACTICE PREMIUMS CHANGE IN 2024?
DECREASE 2%
INCREASE 32%
STAY THE SAME 45%
DO YOU BELIEVE PRIMARY CARE PHYSICIANS ARE UNDERPAID?
YES 91%!!!
NO 7%
NOT SURE 2%
COMMENTS FROM SURVEY PARTICIPANTS:
“Physicians exist in an uneven playing field. Every other part of health care (pharma,
devices, hospitals) is paid according to market forces. But physicians are not. We’re
trapped in a system that ignores economics.”
“Patients are older, sicker, and more obese. At the same time, social media and the internet
fuel unrealistic expectations. Primary care receives far less respect than specialties, even
though we care for the whole patient.”
“Getting into medical school is becoming increasingly difficult for those who would actually
succeed in clinical care. Many students choose specialties or corporate jobs which leaves
fewer options for patients….and fuels [the need for] PA’s and NP’s.”
“Physicians should be allowed to participate in a capitalist system—set our own prices—we
need a reimbursement model that fairly accounts for the rising costs of practicing
medicine.” That model exists, but is ignored causing financial insolvency of practices.
The article included a small graph showing TOTAL INCOME. This was not the overall purpose of the article so I’m omitting this data. Also, it does not say whether the figures are gross revenues or net income after overhead is subtracted. So I think the numbers are misleading and give the wrong impression. And they represent information obtained from doctors, 74% of whom are NOT family doctors, so it’s not pertinent to the discussion.
Reference: Medical Economics 96th Physician Report Medical Economics 2025 July/August: 21-28.
