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THURSDAY, April 22 (HealthDayNews) -- Most black doctors are unhappy with their chosen careers.

A combination of limited access to health insurance for their patients, the cost of medical malpractice insurance, and slow reimbursement rates headed the list of concerns unearthed by a new survey.

"When I got the preliminary findings, I said, no, this can't be right," said principal investigator Dr. Sharon Allison-Ottey. "This is a huge problem, a big red flag for the health of this nation."

The survey, which was conducted by the National Medical Association with support from Pfizer Inc., is called the first national survey of black physicians' perceptions and attitudes about the medical profession. The National Medical Association was founded in 1895 and represents the interests of more than 25,000 black physicians.

The findings were announced Wednesday at the National Press Club in Washington, D.C., and will appear in the April issue of the Journal of the National Medical Association.

As the survey noted, black physicians make up 3 percent to 5 percent of all doctors in the United States, yet their patient base is 67 percent minority.

One of the more troubling findings was that 76 percent of the 479 physicians surveyed said they had retired within the past year or expected to retire soon.

"Where do these patients go? Who do they get their health care from?" Allison-Ottey asked. "The Institute of Medicine recommended that we increase diversity in the physician workforce. This can potentially create a huge vacuum."

Nearly a quarter of the doctors indicated "the loss of joy in medicine as a primary or major reason" for making the decision to retire.

Health insurance was also high on the list of complaints. The overwhelming majority of respondents (90 percent) said inequities in patient access to health care was "extremely important." Tort reform came a close second with 88 percent of the votes, followed by reimbursement issues (83 percent).

Almost three-quarters of the doctors (73 percent) said they weren't satisfied with their medical liability coverage, and 18 percent said that getting this insurance was "the biggest problem I've faced this year." Almost 62 percent said their liability insurance rates "went up significantly" or "went up somewhat" in the last three years. Many also indicated problems paying for the insurance.

Reimbursement issues also surfaced repeatedly in the survey responses. More than half of the physicians said they had "personally experienced a problem or annoyance" in getting reimbursed by insurers. Half or almost half were "not at all satisfied" with changes in Medicare and Medicaid reimbursement.

Paperwork and decreasing time allotments for each patient were also cited as reasons for dissatisfaction.

Almost half the doctors said they were dissatisfied with how they were being treated by managed care organizations.

At the same time, physicians expressed concern and caring for their patients and almost 40 percent said they had "passion" for their chosen field.

"Part of it is from frustrated physicians, stressed-out physicians, underpaid physicians, the physician with more obstacles each and every day. But irrespective of all of that, they are still trying to put on their white coat and see their patients," Allison-Ottey said.

More information

Learn more about black health-care issues at the National Medical Association or the Office of Minority Health.

(SOURCES: Sharon Allison-Ottey, M.D., internist and geriatrician, COSHAR Medical Inc., Baltimore; April 21, 2004, presentation, National Medical Association survey, April 2004 Journal of the National Medical Association)

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