The environment in which physicians practice is ever evolving, but in recent years, the changes have some wondering: Is this the end of a golden age for physicians?
In some ways, yes.
“What we are leaving is the way medicine was done 10 or 20 years ago, which may feel like the golden age if that’s when you were trained,” Sean Reinhardt, MD, vice president and chief medical officer at Penn Medicine Doylestown (Pa.) Health, told Becker’s. “The only constant is change, and the key to success is adapting to that change.”
The changes from the last 20 or more years have been significant.
“The external pressures that clinicians and physicians face today are very different from what we experienced 25 or 30 years ago,” Michael White, MD, executive vice president and chief clinical officer at Valleywise Health in Phoenix, told Becker’s. “Back then, we had more independent physician practices, and patients were hospitalized for conditions we now treat at home. Practicing medicine today and the challenges are very different than it was in the past.”
These challenges include a greater concentration of illness in hospitalized patients, an increase in ongoing surveillance and technology use that puts more demands on physicians’ time, all among increased costs and less pay, leaders said. These changes have made it difficult for some to practice.
“There was a time in medicine when it was easier to survive as a solo practitioner or as part of a small practice,” Nariman Heshmati, MD, chief physician and operations executive at Fort Myers, Fla.-based Lee Physician Group, told Becker’s. “With increasing regulations, rising cost pressures, and a physician Medicare fee schedule that hasn’t kept pace with inflation — in fact, it’s gone down by over 40% in the last two decades — it’s become much harder to start and sustain your own practice. For the first time, we’re seeing more physicians opt for employment straight out of training rather than going out on their own.”
But the drive and passion physicians have to serve patients and build a practice are unchanged. They are just being channeled differently now, Dr. Heshmati said.
Ultimately, physicians are creating “a different kind of golden age,” Syed Raza, MD, chief medical officer at Houston-based Baylor St. Luke’s Medical Center, told Becker’s. “The golden age where it was great to be a physician — that’s over. The idea that you have your set of patients, and the more patients you see, the more income you make — that’s behind us, and honestly, it’s OK to let that model go.”
Letting those old models go is allowing a new age to dawn.
The current practice environment is different from the past, but the prospects for the future are “extremely exciting,” Joseph St. Geme III, MD, physician-in-chief and chair of the department of pediatrics at Children’s Hospital of Philadelphia, told Becker’s.
A new age dawning
No one knows what this new age will be called, but here are predictions from five leaders, along with the elements to which physicians can look forward.
Dr. Heshmati: “I don’t know what people will eventually call it, but I do think the expectations and focus of healthcare delivery are shifting significantly. First, we’re becoming much more consumer-friendly. Patients now expect ready access to care, information at their fingertips and the ability to participate actively in their treatment plans. That shift is major. Second, I think we’re finally entering a stage where we’re truly focused on efficiency and cost-effectiveness. We’ve talked about it for years, but now we’re starting to see it materialize. Healthcare systems are becoming more nimble. Imagine if a parent could avoid spending hours on the phone and taking a day off work just to get their sick child care. What if there was a home module, a virtual visit or tech-enabled diagnostic tool, that provided quick, accurate care at a fraction of the cost? That’s where we’re going. And if we do it right, this new age could be just as exciting — if not more — than the one before it.”
Dr. Raza: “We’re moving from a golden age for physicians into, hopefully, a golden age for patients. The age we’re entering now is more patient-centric and quality-based. Your ability to truly care for patients — to meet all their needs, improve their life expectancy and enhance their quality of life — is more important than the sheer volume of patients you see. Physicians no longer need to work extremely long hours just to prove they’re doing a good job. Instead, they should be caring for a smaller number of patients and providing exceptional care to each of them. That, to me, is the end goal, especially with the broader shift happening in medicine.”
Dr. Reinhardt: “We’re entering the golden age of medicine. AI, gene editing and other breakthroughs will dramatically change the way we work and treat patients for the better.”
Dr. St. Geme: “In my view, we’re entering the golden age for physicians. Technologic advances are positioning us to have unprecedented impact on patients and families, allowing definitive diagnosis of previously enigmatic conditions and facilitating definitive treatment for a growing number of diagnoses. Our approach to enhancing the patient experience has changed significantly and will continue to evolve in ways that are beneficial for patients and can be beneficial for physicians as well.”
Dr. White: “I’d call it the age of partnership. This new age of physicians is about asking: How do we truly partner with our patients? How do we help them improve their health and navigate their journey toward a fulfilling, meaningful life? It’s about providing patients with the information they need to make the right decisions guided by the best evidence we have today. But it’s also about being open to new ideas, trying new approaches and continuing to evolve the practice of medicine. Ultimately, it’s about maximizing our impact — creating better outcomes for the individuals and communities we serve.”
