Consolidation is eroding quality of U.S. health care, doctors say

© The Physicians Foundation

Consolidation in the U.S. health care system is chipping away at quality of patient care, according to the doctors who treat patients daily.

The Physicians Foundation published the findings of its “2024 Survey of America’s Current and Future Physicians,” a poll about the state of physicians and medical students across the nation.

“Across the nation, the overall well-being of physicians has a profound impact on their professional lives and the quality of care they can provide to their patients,” Foundation President Gary Price, MD, MBA, said in a news release.

“Even before the pandemic, physician well-being was in jeopardy; now, the rapid pace of health care consolidation is further deteriorating the practice environment,” he said. “As changes to the health care landscape increasingly restrict physicians’ autonomy to care for their patients, it is imperative that we implement solutions now.”

The results were published Sept. 17, National Physician Suicide Awareness Day, as a call for supporters to continue advocating for doctors to ensure a strong and sustainable health care system, according to the Foundation.

Health care is getting worse, not better, when fewer owners control it, according to the survey results. Seven in 10 physicians and medical students, and at least six in 10 residents, said consolidation is having negative effects on patient access to high-quality, cost-effective care. According to the survey respondents, the results of continuing mergers and acquisitions include:

• Physician job satisfaction, 50%
• Quality of patient care, 36%
• Independent medical judgment, 35%
• Patient costs, 30%
• Safeguards to practice

A full 90% of doctors, residents and medical students called for safeguards to preserve physician autonomy, while 87% agreed on the need to maintain patient standards, 86% want to increase transparency and disclosure. The respondents were less keen on increased regulatory oversight – 46% for physicians and 50% of residents agreed with that.

The survey contained quotations from answers to an open-ended question about programs, services and resources most helpful to doctors working in practices and hospitals negatively affected by health care consolidation.

“Patient care as a whole suffers because we are paying attention to the bottom line and not the actual quality of care that we provide,” one physician said.

Private equity investment

The survey posted noticeable upticks in physician feelings about negative effects of private equity investment in health care. Regarding the statement: “Private equity funding is good for the future of health care,” 56% of physicians and 49% of medical students strongly or somewhat disagreed, compared with 48% and 42%, respectively, in 2023. This year’s result included 48% of primary care physicians disagreeing that private equity investment is good for the future of health care.

As for hospital and practice finance, 71% of doctors, 66% of residents and 64% of medical students agreed financial gain is the top priority, according to the Foundation survey.

Physician burnout

The Foundation’s report stated: “For the fourth year in a row, six in (10) physicians often have feelings of burnout, compared to four in (10) before the pandemic in 2018.” Resident burnout had the same percentage. However, fewer doctors reporting feeling hopeless or without purpose; that rate was 30%, down from 34% to 35% in years 2021 to 2023. The percentage of doctors withdrawing from family, friends, or co-workers was 38%, down from 42% in 2023 and 46% in 2022 and 2021.

One solution: cutting administrative burdens, listed as helpful by 79% of physicians and 87% of residents. A full 71% of residents and 59% of students said it would be helpful to change or remove medical licensure questions that stigmatize doctors who seek behavioral health care.

“Our nation’s physicians are facing a mental health crisis,” Corey Feist, JD, MBA, co-founder and CEO of the Dr. Lorna Breen Heroes’ Foundation, said in the news release.

“As we navigate the complexities of an evolving healthcare landscape, it is imperative that we prioritize the wellbeing and mental health of our physicians, residents and medical students,” Feist said. “Together, we can accelerate solutions – from reducing administrative burdens to breaking down barriers to accessing mental health care – that support and empower physicians to achieve their optimal state of well-being and provide the best care for their patients.”