This article from Health Affairs is from over the pond, but it chimes with much of the conversations you hear in hospital corridors here (if you want to know what is going on in institution don’t go to meetings or read minutes — listen to what those outside the meeting rooms say).
The strain that third-party payers and other practice intrusions have put on physicians is obvious to those who know physicians or work with them, and it is evident from the 2014 Physicians Foundation survey.3 Fifty-six percent of respondents described their feelings about the medical profession as negative, and 51 percent said that they were pessimistic about the future of the profession. Fifty percent would not recommend medicine as a career to their children, and 29 percent would not choose to be a physician if they had their careers to do over.
The article points out the move to employee status (rather than independent practice), and the resulting loss of the patient voice: ‘ “ownership” of the patient in this model may no longer be personal but institutional’
Despite these changes, the medical profession will doubtless continue to exist, as there is no lack of young people vying to get into it (applications to medical school were at an all-time high in 2015).14 The question is, Will medicine remain a calling with patient care at its heart or become a mere occupation, characterized by bureaucracy and a focus on the bottom line? The former is to be hoped for, but given current trends, the latter should be anticipated.
I wonder if we will start to see a broadening of post med school career choices. As in some parts of Europe, many graduates will not go into traditional medical practice. Do I find this all depressing? No, quite the opposite in fact, but we need to ensure that we educate our students about the possibilities.