Burdensome Regulations Pushing Doctors Out of Medicine

By Twila Brase, RN, PHN, president and co-founder, Citizens’ Council for Health Freedom and author of the new book, “Big Brother in the Exam Room: The Dangerous Truth About Electronic Health Records.

Twila Brase

According to a recent study from the Association of American Medical Colleges (AAMC), the nation may face a shortage of nearly 122,000 physicians by 2032, Healthcare Dive has reported.

In part, the article blames the shortage on the “graying” of America, as both medical professionals and patients age, stating that “one-third of active doctors will be older than 65 within the next decade.”

But our organization believes the impending shortage has much more to do with the state of health care today, which is causing doctors to leave the practice of medicine—or not enter the field in the first place. In fact, many physicians now discourage their own children from following in their footsteps.

The shortage is less about doctors with gray hair, it’s about what Congress, regulators and health plans have done to cause doctors to pull out their hair. As evidence, a separate recent study found that a majority of doctors say “barriers set by insurance plans have led to worsened conditions for patients in need of care.”

Researchers with Aimed Alliance found that doctors are so fed up with the constant headaches caused by insurers, two-thirds would recommend against pursuing a career in medicine, and nearly half (48%) are considering a career change altogether. Unfortunately for patients, every exiting physician takes decades of expertise and experience with them never to be used again for care and cure.

Another culprit is the mandated government-certified electronic health records (EHRs), which is forcing doctors to use a technology system that wasn’t made for patient care. The EHRs have been called clunky and cumbersome. Studies also show that physicians spend twice as much time tending to the computer as they spend tending to the patient.

The title of a March 2019 report by Kaiser Health News and Fortune tells a cautionary tale: “Death By 1,000 Clicks: Where Electronic Health Records Went Wrong.” Patients are being harmed. Some have died. This reality weighs on the medical ethics and personal conscience of each physician struggling to not only take care of patients, but to work around the technology that is making that care more difficult and more hazardous.

The EHR is also intrusive, collecting and sharing confidential data without patient consent as permitted by HIPAA. Tom Davis, MD, walked away from his practice because of the EHR. One of his concerns was the use of patient data for purposes that do not directly benefit the patient “so it would be unethical for him to represent otherwise to the patient,” reports Medical Economics.

How does this trend impact patients? For one, patients may lose their longtime doctors who retire early or change careers because of these unnecessary but very real frustrations. Americans think we have the best medical care in the world, and yet highly-trained physicians are hanging up their stethoscopes early as 10,000 senior citizens enter Medicare every day, expecting doctors to be there when they need them.

This desire to exit the practice of medicine early is not subsiding. In my book, “Big Brother in the Exam Room,” I cite a 2016 physicians survey, which also found that 48 percent of doctors were considering leaving patient care or making a drastic reduction in the number of patients they see.

And since the July release of that book, a 2018 updated survey shows great frustration, with 89.5 percent of physicians saying they have “somewhat,” “little” or “very little” influence in today’s health care system. And even though doctors said patient relationships are “their greatest sources of professional satisfaction,” the survey finds 78 percent of doctors sometimes, often or always experience burnout—perhaps because doctors said EHRs are “their greatest source of professional dissatisfaction.”

This mass exodus is a crisis perpetuated by government policy and the preponderance of third-party payment for medical care. As a result, medicine is no longer the job doctors signed up for, nor the profession they dedicated their life to or went to school a decade or more to achieve. Physicians choose medicine because they are on a mission to improve and save patients’ lives, but that mission has been thwarted by Congress, regulators and payers who force doctors to prioritize data entry and third-party protocols over patient care.

Patients in America will always need doctors. But in this land of freedom, no one is required to choose medicine as a career. Therefore, payers and policymakers should reconsider the onerous burdens and intrusive requirements that have been placed on the practice of medicine. They should give doctors a reason to stay.


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