Physician shortage could worsen if decline in fees, hours worked, continues

A decline in the number of hours worked by doctors correlates with a gradual drop-off of physician fees since 1995, reports a study recently published in the Journal of the American Medical Association. If the trend continues, the physician shortage in the U.S. could become worse, the authors conclude.

"You would be hard-pressed to find a profession that has experienced such a drop in hours over a decade," said lead author Douglas O. Staiger, an economist at Dartmouth College in New Hampshire, Bloomberg reports. "We concluded that doctors weren't seeing either the financial or nonfinancial rewards that made it worth working that last hour." 

From 1989 to 1995, physician fees essentially remained at the same level, according to the study. From 1995 through 2006 however, there was a noticeable drop-off in physician's fees, so much so that by 2006, such fees were 25 percent lower than their inflation-adjusted levels from a decade earlier. 

Correspondingly, physician hours worked hovered between 54.6 and 55.9 per week from 1977 until 1997, but over the next 10 years fell by roughly four hours per week to 51 hours per week. 

While the prospect of a continuing physician shortage lingers--currently some parts of the U.S. have "16,787 too few physicians to meet a...medically appropriate ratio of one doctor for every 2,000 residents"--the study's authors still believe that there's more to this equation than just money. 

"When fees decrease, a physician earns less for working an additional hour, all else equal, and may have less incentive to work long hours," the study reads. "However, the evidence on the relationship between fees and work hours is mixed, with some studies finding that lower fees encourage physicians to work more hours to achieve a target income." 

To learn more:
- check out the study in JAMA
- read this Bloomberg article

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