Understanding Hobson’s Choice in Healthcare

Posted on September 28, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd CMP™

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Hobson’s Choice in Medicine

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Hobson’s choice is a free choice in which only one thing is actually offered. The term is often used to describe an illusion that choices are available. The best known example is “I’ll give you a choice: Take it or leave it”, wherein “leaving it” is strongly undesirable.

The phrase is said to have originated with Thomas Hobson (1544–1631), a livery stable owner in Cambridge, England, who offered customers the choice of either taking the horse in the stall nearest to the door or taking none at all.

A CASE MODEL

Half of Physicians Plan to Change Career Paths

The Physicians Foundation recently conducted a survey on physician practice patterns and perspectives. Here are some key findings from the report:

• 31% of physicians identify as independent practice owners or partners.
• Almost half (47%) of physicians plan to change career paths.
• 78% of physicians sometimes, often or always experience feelings of burnout.
• Nearly a quarter of physician time is spent on non-clinical paperwork.

This result is not a good Hobson’s Choice in Medicine.

Cite: The Physicians Foundation, September 2018

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Are Doctors Throwing in the Towel?

Posted on April 21, 2011 by Dr. David Edward Marcinko MBA MEd CMP™

Doctors versus Insurers

By Staff Reporters

Despite the success of entrepreneurial doctors – the number of doctors who enter private practice are in decline.

The Survey

For example, according to a survey by the “Physicians Foundation”, 89% of respondents believe the traditional model of independent private practice “is a dinosaur soon to go extinct.”

Survey: http://www.physiciansfoundations.org/uploadedFiles/Health%20Reform%20and%20the%20Decline%20of%20Physician%20Private%20Practice.pdf

Pod Cast: http://healthystate.org/archives/5764

Assessment

So we ask; what do you think?

Are physicians “throwing in the towel” and leaving private medical practice?  

Conclusion

Your thoughts and comments on this ME-P are appreciated. Our goal is to prevent same. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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Is Primary Care Medicine Toxic?

Posted on December 17, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

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Requesting Real-Life Examples of Professional Despair

By Dr. David Edward Marcinko MBA CMP™

www.BusinessofMedicalPractice.com

[Editor-in-Chief]

As you’ve probably heard – and experienced or know from our books, journal and this ME-P – there’s a primary care medical shortage out-there!  Maybe you’ve even read or heard about the Physician’s Foundation study describing the overwhelming number of PCPs who want out of this toxic environment. On one hand, we have patients desperately searching for a PCP, while on the other hand we have good caring doctors being forced out of the profession. Of course, NPs, ANPs, DNPs and other ancillaries are part of the solution; but not entirely.

Link: http://www.physiciansfoundation.org/

Human Anguish

And humanely, as stated by our medical colleague L. Gordon Moore MD, these statistics miss the very real pain and anguish of people who entered primary care to help patients when they find the environment for primary care toxic to the ethical practice of medicine. Even to the point of suicide!

Assessment

These voices need to be heard. And so, we are asking doctors and providers of all stripes to post in the comments section below personal examples of medical practitioners leaving primary, solo or small group practice because they just can’t stand the toxic environment any longer.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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Doctor Discontent

Posted on December 2, 2008 by Dr. David Edward Marcinko MBA MEd CMP™

Physician’s Foundation Survey Results

Staff Reporters

According to the Wall Street Journal, November 18, 2008, doctors reported a variety of professional discontents in a survey conducted by the Physicians’ Foundation, to which 11,950 primary care physicians and specialists responded.

Legal Origins

The Physicians’ Foundation, began in 2003 through the settlement of a class-action lawsuit brought by doctors and medical associations against private insurers, says it seeks to “advance the work of practicing physicians and to improve the quality of health care for all Americans,” And, its most recent survey found that:

Survey Results:

  • 94 percent of respondents said the time they’ve devote to non-clinical paperwork in the past three years has increased, while 63 percent said the paperwork has meant they spend less time per patient.
  • 82 percent said their practices would be “unsustainable” if proposed Medicare pay cuts were made.
  • 78 percent believe there is a shortage of primary care docs in the U.S.
  • 49 percent said that over the next three years they plan to reduce the number of patients they see or stop practicing entirely.
  • 60 percent would not recommend medicine as a career to young people.
  • 42 percent said professional morale is either “poor” or “very low.”
  • 17 percent rated the financial position of their practices as “healthy and profitable.”

Assessment

Perhaps the most unpleasant finding was that only 06 percent described the morale of their colleagues as “positive.”

Conclusion

And so, your thoughts and comments on this Executive-Post are appreciated. Do you essentially agree, or disagree, with these results?

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