Work hours for U.S. doctors dropped steadily for more than a decade, mirroring a decline in inflation-adjusted fees and worsening a nationwide physician shortage, a study said.
Doctors’ hours per week fell to an average of 51 in 2008 from 55 in 1996, after two decades of being almost unchanged, according to research published Wednesday in the Journal of the American Medical Association. The report showed the slide was linked to a falloff in fees paid to physicians. The charges declined 25 percent after inflation from 1995 to 2006, according to an index measure of fees going to doctors.
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The U.S. is suffering a nationwide shortage of practitioners that has left some Americans without a primary care doctor and has caused hospital emergency rooms to be overcrowded, the American College of Physicians said. Pressure may mount if the federal government is successful in extending medical insurance to an additional 31 million Americans in the proposed health overhaul, said the authors of Wednesday’s report.
“You would be hard-pressed to find a profession that has experienced such a drop in hours over a decade,” said Douglas O. Staiger, one of the study’s authors who is an economist at Dartmouth College in Hanover, N.H. “We concluded that doctors weren’t seeing either the financial or nonfinancial rewards that made it worth working that last hour.”
The stagnant number of doctors has already left parts of the U.S. with 16,787 too few physicians to meet a federally set, “medically appropriate” ratio of one doctor for every 2,000 residents, according to the U.S. Health Resources and Services Administration.
Doctors and economists have debated whether there is a shortfall or simply uneven distribution by geography and by medical specialty. Some cite mounting evidence from Massachusetts, where health insurance expansion has enabled 97 percent of residents to have medical coverage and patients are waiting longer to get an initial doctor’s appointment, or having trouble getting one at all.
The average waiting time to see a family medicine doctor in Boston, a city with 14 teaching hospitals, is 63 days, the longest among 15 cities in a 2009 survey by Merritt Hawkins & Associates, a recruiting and research firm in Irving, Texas.
“While there has been growth in the number of doctors, it has slowed over the last decade,” Staiger said. “Clearly, something unique is going on with physicians, and it is somehow tied to declining fees.”
