The results of two surveys of primary care physicians, conducted 10 years apart, suggest that the level of dissatisfaction with the practice of medicine has markedly risen.
The reality of medical practice has changed over the last 10 years and the disparity between expectations and reality has driven this downward movement in satisfaction.
Researchers evaluated the results of two surveys of primary care physicians: the Medical Outcomes Study, conducted between 1986 and 1990 in Boston, Chicago and Los Angeles, included 583 physicians; and the Study of Primary Care Performance in Massachusetts, conducted between 1996 and 1999, included 992 physicians.
Over the period of the two surveys, the investigators found a sharp decline in multiple aspects of physician satisfaction with their professional life. Many of the changes in medical practice over the past decade, including managed care and large medical groups that contract with health plans, have caught physicians who went into practice decades ago off guard.
Physicians showed the most dissatisfaction with their professional autonomy, amount of leisure time available and with the time available to spend with individual patients. In addition, physician satisfaction with their total earnings also sharply declined. In 1986 about 75% of the physicians said that they were satisfied or very satisfied with their total earnings, and in 1997 that number dropped to 55%.
These feelings of professional dissatisfaction have resulted in higher rates of older physicians taking early retirement. Physicians who have trained more recently are less surprised by what medicine looks like today, whereas physicians who have been in practice longer find the pressures of productivity and competitiveness an unwelcome surprise, which they regard as questioning their professional judgment and their technical expertness.
Journal of General Internal Medicine July, 2001;16:451-459
This study touches on a large part of the problem with traditional medicine. Physicians are not happy where they currently are, as a result of a perceived loss of their competence. Although they have improved their ability to symptomatically treat disease, they are relatively clueless when it comes to resolving the underlying disorders of their patients.
What has changed is that there is an ever increasing number of natural medicine practitioners who understand the truth and are helping people resolve the root causes of their illnesses. Physicians are receiving this feedback in ever increasing numbers. They are beginning to understand that their traditional paradigm is fatally flawed for most illness.
Competence and autonomy are essential in the pursuit of happiness. So when the perceived loss of competence is integrated with the managed care infiltration into medicine and subsequent loss of autonomy, physicians are in the classic equation for a position which is often destined to make them unhappy.
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