Like many who suffer through the seasonal allergies that plague us in Central Texas, I recently found myself in a doctor’s office. But, this was a new experience for me. My doctor – a longtime sole practitioner with his own office – had recently formed a practice with a number of other physicians.
As it happens, he’s not alone.
The American Medical Association (AMA) reported in its 2012 Practice Benchmark Survey that a slight majority (53 percent) of physicians owned their practices, down from 61 percent in 2007/2008. For family medicine, the percentage of physicians who owned their practices was 40 percent. And, according to consulting firm Accenture’s 2015 Independent Physician Outlook Summary, the independent physician is a swiftly shrinking segment, with numbers predicted to drop to 33 percent this year.
- Medscape’s Employed Doctor’s Report observes financial security is the most cited reason for employment, noted by just more than one-third (36 percent) of employed physicians. This is especially true for younger physicians, who overwhelmingly prefer employment. Physicians under age 40, often saddled with student loans, are twice as likely to be employed than self-employed (23 percent versus 11 percent).
- According to a recent survey fielded by the American Association of Medical Society Executives, 37 percent of physicians say they did not want to deal with the administrative hassles of owning a practice. The same study also reports 33 percent of respondents say they wanted to be a doctor, not a businessperson. Overall, the lifestyle that employment offers is a significant underlying factor driving physicians to employment. For physicians who left private practice, the majority attribute their decision to high overhead costs. Reimbursement cuts, lack of resources to comply with ACA requirements, and the administrative hassles of ownership are other significant reasons cited.
- Women make up 33 percent of the physician workforce, and a larger percentage of them are employed than are men. Some female physicians are attracted to the “work-life balance” more often afforded by employment – predictable hours, often without call responsibilities.
How This Shift is Impacting Medical Societies
Call it occupational hazard, call it too much time in the waiting room thumbing through a medical journal, but it occurred to me that these trends – trends impacting me in my own life – represent a considerable shift, not only within the medical field, but also for those medical societies and organizations serving the healthcare industry.
Interest in these organizations remains strong, but show some potential signs of weakening. Per The Physician’s Foundation 2016 Survey of America’s Physicians:
- Doctors most frequently join their national specialty society and their state medical society. Some 78.5 percent of 2016 survey respondents say they’re members of their national specialty society, down slightly from 79.7 percent in 2014.
- More than 61 percent indicate they’re members of their state medical society, roughly the same as in 2014, and down slightly from 2012. It’s worth noting, owners (sole practitioners) were almost 20 percentage points more likely to belong to their county and state medical society than their employed peers.
- About 41 percent say they’re members of their county medical society, about the same as in 2014, but down from 63.6 percent in 2012.
Proving Your Worth to Employed Physicians
The research mirrors much of what’s been seen in other verticals for some time – members reporting they no longer “need” to be members. Core services once provided by county and state societies – such as practice support with coding and reimbursement assistance — are now handled by their employer. Employers are also more likely to provide continuing medical education (CME) and other educational offerings, taking another point of differentiation away from the societies competing for their membership.
So, what can medical societies do? The first step is to answer what seems like a basic question: Who are your members? We’ve talked a great deal in our Member Engagement Study about the need to segment and understand demographics beyond the existing membership type. Evaluating members based on their employment status and assessing program effectiveness and engagement through that perspective may provide keen insights on alternative membership models (or, at the very least, adjustments) that may prove helpful in strengthening member retention.
In addition to revisiting membership offers, there are opportunities, too, to explore how best to drive engagement among this growing population of employed physicians. Some ideas include:
- Advocacy: The National Conference of State Legislatures (NCSL) identified nearly 1,200 pieces of active legislation in 2014 related to the implementation of the Affordable Care Act (ACA). Also? There was an election last week – there is likely further change to navigate.
- Leadership Development: When asked what they didn’t like about their work, Medscape reports’ employed physicians often cited lack of control and autonomy. These categories include limited influence in decision making (cited by 35 percent), less control over work and their schedules (28 percent), too many rules (26 percent), being “bossed around” (22 percent), and less autonomy (20 percent). As physicians move into leadership roles in large groups and hospitals/health systems, the skillset they learned in medical school needs to be complemented by leadership competencies of how to navigate in a new organizational structure.
- Networking and Mentoring: In addition to ad-hoc networking programs, mentoring programs that match physicians new to practice or new to the area with more seasoned doctors can prove especially effective. These programs can go a long way to supporting early career physicians and deepening engagement both with new members and those who have been on board for a much longer time.
- Distribution of Need-to-Know Information: Regardless of employment, physicians need to know how new regulations, research, and trends will impact their practice. Organizations still serve as a trusted source of information in the very uncertain and changing healthcare environment.
- Continuing Medical Education (CME): A core benefit of many medical societies is the ability to earn free or reduced price continuing medical education as part of membership. To serve employed physicians, organizations could choose to work with specific groups and/or systems to co-brand or collaboratively design CME programs. Another strategy is to provide specialty-specific or geographically-specific expertise that would be hard for others to provide as expertly or as well.
- Physician Well-Being: According to The Physician’s Foundation, 54 percent of physicians rate their morale as somewhat or very negative. Nearly half (49 percent) often or always experience feelings of burnout. Managing stress, avoiding burnout, balancing medical practice with personal goals and relationships, financial planning, and how to succeed in different kinds of practice environments are all possible areas for medical society programming, regardless of specialty or geography.
Physician employment may be changing how many physicians view their medical societies and the expectations they bring to their membership. Yet medical societies continue to evolve and succeed across the United States. New technologies allow us to connect to more physicians in new and more effective ways, and to be proactive in the ways in which we monitor larger shifts in membership.
Perhaps by taking a dose of their own medicine – taking a preventative approach designed to protect, promote, and maintain organizational health and well-being – medical societies can look forward to a long and happy life.