Shadi Jarjous, MD, chief of hospital medicine at Allentown, Pa.-based Lehigh Valley Health Network, spoke with Becker’s about the systemic changes that could make medicine a more attractive career path for the next generation of students.
With growing concerns about physician burnout, workforce shortage and medical school enrollment pressures, Dr. Jarjous highlighted four critical areas where reforms are needed:
A greater focus on medicine’s business side
“One of the main issues is that people who pursue medicine often aren’t prepared for real life,” Dr. Jarjous told Becker’s.
Medical education is still overwhelmingly focused on clinical and scientific training, while neglecting the operational, financial and administrative realities of practicing medicine. This disconnect can lead to a harsh reality check for newly minted physicians who suddenly face billing systems, insurance complexities and productivity metrics.
Only 18% of physicians receive any business or executive training during medical school and just 21% of healthcare organizations offer formal leadership development programs for physicians, according to a survey by Jackson Physician Search and the Medical Group Management Association.
Dr. Jarjous emphasized that integrating these topics into medical school curricula, including healthcare economics, contracts, leadership and negotiation, could better prepare students for the reality of modern medicine.
Reducing administrative burden
Another pressing issue is the administrative load that weighs on physicians, consuming time and energy that could be spent on patient care.
Minimizing administrative burden, like improving EMR and reducing time spent on paperwork, would go a long way toward making medicine more enjoyable, Dr. Jarjous said.
In 2023, physicians reported working an average of 59 hours per week, with just 27.3 of those hours spent in direct patient care, according to a report from the American Medical Association. The remaining time was divided between indirect patient care (14.1 hours) and administrative tasks (7.9 hours), including documentation, billing and compliance requirements.
Restoring clinical autonomy
As healthcare continues to consolidate, many physicians feel their decision-making power is being eroded.
“Autonomy is also important,” Dr. Jarjous said. “Most clinicians now work in big health systems, and as healthcare becomes more consolidated, it’s critical to allow clinicians some control. Systems that do that tend to be more successful.”
A survey from the National Opinion Research Center at the University of Chicago found that 61% of employed physicians reported having moderate or no autonomy when making referrals outside their practice or ownership system. Nearly half, 47%, said they adjust treatment options based on practice policies or cost-reduction incentives, even when those adjustments might not reflect their preferred clinical judgment.
Tackling the cost of training
The financial burden of becoming a physician is a major deterrent for many prospective students. Medical school graduates carry an average debt load of $243,483, including pre-medical school debt, according to the Education Data Initiative. For those receiving substantial scholarships, the debt still averages $115,000 to $130,000, depending on whether they attended a public or private institution.
“Most people aren’t done until their 30s and accumulate significant debt,” Dr. Jarjous said. “That discourages people, especially when they see alternative career paths where they can start earning right away.”
From 1998 to 2019, the average debt for medical school graduates increased 48.5%, outpacing inflation and wage growth in most sectors. Addressing the affordability of medical education — through tuition reform, loan forgiveness or expanded scholarships — will be essential to keep the medical pipeline flowing.
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