fbpx

5 Disturbing Trends That Signify the End of “Job Security” in Healthcare

Quick summary: This post examines the causative factors of the health care crisis, culminating in 2020 with the COVID-19 pandemic. It then examines 5 disturbing trends threatening the "job security" of physicians, and offers several solutions.

It took just over 20 years for physicians to witness the erosion of the once prosperous profession of medicine. With the institution of managed care, physician benefits such as compensation, autonomy, lifestyle, job security, and career satisfaction have all but disappeared.

Tectonic shifts including the internet, increasing competition from globalization, technological disruption, shifting marketplace dynamics, generational differences, and unsustainable business models have forced the medical field to evolve from a profession devoted to serving patients into a profit-driven business controlled by insurance, business executives, lawyers, and politicians. “Black swan” events such as 9/11, the 2008 financial crisis, and the ongoing COVID-19 pandemic have precipitated a worsening of this trend.

The current model of healthcare in the U.S. has been unsustainable for decades with costs out of proportion to the level of care provided.

As we’ve witnessed firsthand, hospitals continue to be overwhelmed. They needed greater provider support but could not afford nor protect them. Yet, many hospitals recorded huge profits from federal stimulus programs last year.

 

The following are 5 disturbing trends that signify the end of “job security” in healthcare, and potential solutions to address the problem:

 

  • Losing the healthcare workforce. In addition to typical retirement at the end of a long career, the profession is losing a large portion of its younger workforce due to burnout, lack of career fulfillment, and career exodus from physicians less than 5 years out of training. According to the American Association of Medical Colleges, the U.S. is predicted to have a massive shortage of physicians estimated between 37,800 and 124,000 physicians by 2034. Staffing shortages are leading hospitals to replace physicians with nurse practitioners and physician assistants. In other cases, hospitals are closing or merging with larger entities.
  • Increasing physician unemployment. To combat the predicament of a physician shortage by 2034, new medical schools are opening across the country, and existing schools are increasing their enrollments. However, residency-completion and board-certification are prerequisites for practicing, and the Accreditation Council for Graduate Medical Education (ACGME) is increasing the number of residency positions and programs at a rate significantly less than the total number of residency applicants each year. Many of these physician graduates carry large student loan burdens and have spouses and children to provide for. Because of this trend, too many graduating physicians will be forced to defer a year or more to obtain a residency, or abandon their dreams of clinical practice altogether.
  • A model towards hospital-based W2 employment. With the consolidation of healthcare systems and physician practices, the trend for physician employment will be towards large hospitals and organizations as opposed to the solo private practitioner model. Smaller entities will not be able to sustain a competitive advantage in today’s healthcare marketplace. From a tax liability standpoint, a W2 income statement offers the least benefits, and severely limits a physician’s choices in terms of practice location and choice of employer.
  • Replacement of physicians by other providers. While the reasons for this trend are multifactorial, an increasing number of physician assistants and nurse practitioners are being employed to provide patient care in roles typically held by physicians. The long-term effects of this trend have started to raise questions among physicians from a financial and patient care standpoint.
  • Buyout of physician practices by private equity. With the for-profit business model in U.S. healthcare, a number of private equity firms have targeted physician group practices for acquisition. According to a research letter published in JAMA in 2020, the number of physician practices acquired increased from 59 to 136 from 2013 to 2016. Anesthesia and multi-specialty groups were targeted as the most attractive, followed by specialties such as emergency medicine, family medicine, and dermatology. While these numbers remain relatively small, this trend is concerning since these practices have the potential to be solely controlled by the interest of shareholders and Wall Street in the future. This places shareholder interests above those of patients and providers.

 

We are on a fast-moving train on a collision course. Our society is in need of a healthy and robust healthcare workforce, but we are witnessing an aging profession, obsolete paradigms, an inability to afford, train, and educate the workforce, increasing regulatory requirements, and an aging population. All of this is happening in the midst of a strained healthcare system brought on by COVID-19. Hospitals have responded by cutting pay, furloughing, laying off workers, increasing requirements, and hiring cheaper replacements, while maintaining their profit margins. These measures serve the business model, while neglecting the underlying provider workforce and compromising patient safety and satisfaction.

Looking back in history, this trend can be seen in the auto and airline industries, among countless others, as a result of clinging to outdated Industrial Age business models. Physicians need a more entrepreneurial mindset and greater advocacy. We need to develop early financial literacy and create multiple streams of passive income independent of our clinical practice so that we can practice medicine on our own terms as opposed to being at the whim of hospital-based decisions. Physicians must wake up and do something about the dire future of the healthcare landscape.

Originally posted on MedPage Today (https://www.medpagetoday.com/opinion/second-opinions/94961).

Tweet this out

Ad from SoMeDocs.

SoMeDocs Front Page Header

Marketing physician voices uniquely!

Our Venture Amplifies Healthcare Voices.

Ad from SoMeDocs.

SoMeDocs Front Page Header

Marketing physician voices uniquely!

Our Venture Amplifies Healthcare Voices.

SoMeDocs

SoMeDocs, short for Doctors on Social Media, is a physician-created & led health media company that aims to build a beautiful catalogue of verified online healthcare voices. Our goals are to teach educated professionals tools for personal success, and to showcase them to the world, and facilitate the connections needed to grow. Join us.

My Life Dimmer Switch

My Life Dimmer Switch

Dympna Weil, MD confesses how owning the dimmer switch of her life changed EVERYTHING. She shares exactly how.

Negotiation series header: David Norris

Negotiate as a Physician and Win

Catch this 8-part series, hosted by physician & business consultant David Norris, MD, MBA & produced by Dana Corriel, MD. Learn to be a stronger negotiator with these important tactics.

Conversations with Shem: Season 2

Medical literature icon Samuel Shem, author of “The House of God” returns for season 2 of conversation, in order to discuss the broken healthcare system. This time, he’s brought the guests!

Doctors on Social Media Teach Podcasting Header Image

Doctors On Social Media Teach Podcasting

Today’s health experts are sharing their expertise in audio format using podcasts. Join us as we explore how we do this and bring on the innovators who are giving it their all.

George Mathew, MD, MBA

George Mathew, MD, MBA

Trying to learn as much as I can about healthcare and the business of healthcare, to try to create access to care for all patients

Roberata E Gebhard D.O.

Roberata E Gebhard D.O.

I am passionate about Gender Equity in Medicine, and I help physicians who have experienced workplace injustice!

Heather Signorelli, DO

Heather Signorelli, DO

Physician executive and entrepreneur on a mission to help physicians through a reliable medical billing service.

Mimi Zieman M.D.

Mimi Zieman M.D.

We all have inner voices that need to be listened to, and stories to tell. Voices speaking up for women and justice are needed now more than ever.

Meridith Grundei

Meridith Grundei

Perfection is highly overrated. It’s time to start getting comfortably uncomfortable and start sharing your voice with the world!

JD Gershbein

JD Gershbein

“Linkedin is like a raffle; you must be present to win.”

Ann M. Richardson, MBA

Ann M. Richardson, MBA

“The Doctor Whisperer” – Healthcare systems transformation consultant and fierce physician, care team, and patient advocate.

SoMeDocs Logo

The Healthcare Connection Hub

Disclaimer: SoMeDocs assumes no responsibility for the accuracy, claims, or content of the individual experts' profiles, contributions and courses. Details within posts cannot be verified. This site does not represent medical advice and you should always consult with your private physician before taking on anything you read online. See SoMeDocs' Terms of Use for more information.

Grow with us.

We take rolling applications for regular contributors

We had a fantastic turnout and brought a large number of physician contributors on board our 1st & 2nd rounds. If you’re interested in being considered for a future round, submit an application now and we’ll be in touch when it opens. Regularly contributing means you share your thoughts, stories, opinions, or advice on our website, and we make it pretty/circulate. It’s essentially our large effort to collectively market health experts and grow thought leaders. We also consider applications for our “Experts for Health Experts” section, depending on the pitch. Are you ready to join us? If you prefer immediate access & want to build yourself space now, consider becoming a member.

Play Video
Our Founder Answers Your BURNING Question

SoMeDocs

“Why should I become a member of SoMeDocs if I already have my own space online?”