Physicians Weigh In On Important Questions

The results of the 9th annual Epocrates Future Physicians of America survey, which has respondants from all fifty states, are in. More than 1,000 future physicians have weighed in on their opinions on a number of important issues including patient care, their satisfaction with the quality of their education, and their plans following graduation. Among these numbers are several interesting statistics, many of which have changed drastically in the last couple of years.

90% of future physicians intend to avoid private practice. In 2008, around 20% of medical school graduates intended to enter into a partnership or start their own practice. By 2013, that number was still around 17%, though the decline was beginning. The latest numbers, however, reflect medical school students who want a balance between their work and their lives. They want to be able to stop working when they take off the white coat at the end of the day rather than having to deal with administrative hassle.

Some of this lack of desire to open or join a private practice is due to the fact that many medical school graduates feel that their education has left them unprepared to deal with the "business end" of a medical practice. Nearly 60% of the students surveyed were dissatisfied with their training in owning and operating a practice, while others admitted to no training at all in billing and coding.

Other students admit that their training is designed around a hospital setting, which many students feel offers them a solution with less stress. At a hospital, one student pointed out, they can begin practicing medicine immediately and without acquiring further debt. The startup costs of opening a private practice can be high. Medical students aren't guaranteed success. At a hospital, however, they can start earning money immediately and whittling down the debt from student loans and other expenses incurred during college. Not only that, in a hospital, students know what they're doing. There are people on hand to handle all of the details of running the hospital; all they have to do is practice medicine. That makes working at a hospital a much more comfortable choice for many medical school graduates.

Future physicians are admirably focused on quality of patient care, which they think involves care coordination and collaboration between all of the physicians, nurses, therapists, and other professionals involved in an individual's care. In fact, 96% of the medical students surveyed believe that collaborative care is one of the most important aspects of patient care. That means that medical students are interested in tools that will able them to communicate effectively with the other individuals involved in their future patients' care.

To go along with this, 60% of the students surveyed believe that one of the greatest challenges to effective care for every patient is a lack of communication. Michael Douglas, a third­year at Loma Linda University of Medicine in California, says it best. "Communication tools are broken or antiquated, and this impedes our ability to provide continuity of care for patients. Despite a clear need for quick, efficient, and secure ways to communicate with and across teams, we’re still stuck in the 90’s using archaic paging systems and fax machines.”

This year's medical school students are in the unique position of seeing a world in which technology has enabled communication as never before. Now, no matter how far away people are, they can communicate with the press of a few buttons. Collaborative sessions involving people from different parts of the world are as simple as setting up the right technology in the right locations. Unfortunately, medical communication technology has been slow to catch up with the rest of the world. Most of the time, it's not the press of a button delivering information from one physician to another or from the physician to a pharmacy. Instead, physicians are reliant on fax machines and other archaic systems that simply aren't effective at transmitting the information needed for the highest quality of patient care.

Future physicians are hopeful, however, about the development of electronic health record systems, which will enable the easy sharing of data across the country over the next several years. While it's taking time to get medical professionals on board with the new system, future physicians are hopeful that it will improve the quality of care for their patients. While 75% of survey respondents acknowledged concerns about cross ­team communication, they are hopeful that the electronic records system will make all of the relevant health information about every patient available for anyone to see.

The electronic health records solution, however, does mean that future physicians and their assistants­ nurses, receptionists, transcriptionists, and the entire team of individuals devoted to the nuances of patient care ­­will need to be up to speed on how to use the system to its fullest advantage. This adjustment should be reflected in the training that medical school students receive, but getting it out to physicians who are already practicing will take time, leading to gaps in patient records. Current medical school students, however, are hopeful that these changes will show real and lasting improvement in the quality of communication across patient care teams within the next decade.