Physicians reflect on new challenges, additions in their practices

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Physicians have been facing many challenges in the last year, with increased competition and lower reimbursement being two of the most prominent. Since 2023, 23% of physicians reported their practice income decreased, while 61% said it had stayed the same. Now, physician practices are aiming to combat these issues through adding patient services and non-physician staffing, according to a survey from MedCentral.

In How Is Medical Practice Evolving, the survey featured responses from 864 physicians in the US on how current health care trends and challenges have impacted their medical practice, including staff and physician shortages, reimbursement issues, and competition from retail clinics, urgent care centers, and more. The survey was conducted from April 16 to May 19.

The burden of administrative work, lack of AI use

A top concern for physicians was the burden of administrative work, with 66% ranking it as the most significant issue for their practice. Another high-ranking response in the survey was reimbursement and staffing issues, at 57% and 56%, respectively.

The survey also found that 66% of physicians were not using artificial intelligence (AI) in their practices. However, those that were found it helped most with medical documentation, billing and coding automation, and differential diagnosis assistance.

New improvements to patient care and efficiency

Many physicians in the study said they either had switched or were considering switching to a new practice model. One in five said they were offering direct primary care (DPC), where the physician does not take insurance and patients pay a monthly or annual retainer for medical care. Meanwhile 23% were considering integrating DPC into their practices.

Nearly one-third said they were also considering incorporating concierge or hybrid practices, where patients utilize insurance, but also pay a retainer. Close to 17% had incorporated urgent care in their practice.

Interestingly, 44% of respondents revealed they had a medical-related side gig, such as medical consulting or moonlighting at a part-time job to earn an extra income.

JoAnn E. Manson, MD, MPH, chief, Division of Preventative Medicine, Brigham and Women’s Hospital and professor at Harvard Medical School, said in a statement: “The MedCentral survey results show that physicians remain resourceful in the face of staffing and reimbursement challenges. Physicians' administrative burdens have remained unaddressed for far too long, and demand attention and new solutions from the health care system.”

New barriers to drug prescribing

While the US Food and Drug Administration (FDA) releases an average of 53 new drugs per year, they don’t often reach the patients who need them. 85% of physicians said the lack of patient access was a major barrier when prescribing new therapies over the last year, with patients unable to get the recommended drug due to either a lack of insurance coverage or cost. Drug shortages were another important factor that 60% of physicians noted.

Additions to staff, services, patient care

56% of respondents had added non-physician practitioners, such as nurse practitioners and physician assistants. Additionally, 55% had added ancillary services to their practices, allowing an easier way to see more patients and give patients more scheduling flexibility and communication options.

The study highlighted some physicians had made several updates to their practices through adding telemedicine, upgrading their patient portal, and modifying their scheduling plan to include same-day or open scheduling. Some also expanded office hours and added lab testing.

Also, 60% of physicians added non-physician practitioners, reporting the staff additions had helped increase profitability.

“Adding non-physician practitioners, leveraging the conveniences of patient portals and same-day appointments, and even taking on additional consulting work ensures that patients can get the care they need when they need it, and physicians can enjoy a more satisfying and rewarding career,” Manson said.