As I read through one particular healthcare-related news item recently, the lyrics to the old “If you’re happy and you know it” song just plain took over my subconscious thinking.

You know the one I’m talking about: “If you’re happy and you know it, then your face will surely show it.”

It may not come as any great surprise that smiles aren’t adorning the faces of too many doctors these days, what with Medicare payment cuts, the looming impact of healthcare reform, skyrocketing malpractice premiums and other lesser complaints and concerns.

But all that notwithstanding, it was just short of astounding to read the results of a recent survey of more than 5,000 physicians by The Doctors Company, a Napa, California-based cooperative that is the nation’s largest medical malpractice insurer.

In response to questions probing the future of healthcare in America, nine out of 10 respondents indicated an unwillingness to recommend healthcare as a profession. I repeat: fully 90% of those respondents who are currently earning a living in the healthcare field said they would not recommend that field to someone looking to start a career.

Yikes! I mean, Mike Rowe of Dirty Jobs fame surely would come up with a better stick-with-it percentage than that, even if he were polling sewage workers or trash collectors.

And we’re not talking just “wouldn’t recommend it.” The physician respondents actually said they would “actively discourage friends and family members from pursuing careers in medicine.”

Perhaps not surprisingly given the level of hopelessness expressed, the Doctors Company survey also saw 43% of respondents – more than four of every 10 – say that they are contemplating retiring within the next five years.

Yikes again.

With some 32 million newly insured patients scheduled to enter the U.S. healthcare system by 2016 under various provisions of what goes by the shorthand tag of Obamacare, an already shorthanded cadre of healthcare professionals is anticipating even more strain on a stressed-out system.

The Doctors Company said the added insureds will increase the number of patients treated per physician, in turn exacerbated by an anticipated shortage of primary care physicians and nurses, “making it nearly impossible to maintain or improve the quality of patient outcomes.” And in the new world of healthcare coverage, patient outcomes are the coin of the realm.

“Sixty-five percent of respondents believe the current legislative initiatives designed to reduce healthcare expenses are insufficient to effectively address the underlying causes of costly defensive medicine,” the Doctors Company said. “Furthermore, the physicians surveyed expressed concern that the increase in patient volume will reduce the attention they are able to give to each patient, with 60% of respondents indicating that the pressures to increase patient volume will negatively impact the level of care they can provide. Fifty-one percent of respondents feel their ability to grow and maintain patient relationships will be adversely affected.”

In all, 60% of the respondents said healthcare reform will have a negative impact on patient care; 20% said the impact would be positive. As for the bottom line, 78% said Obamacare will negatively affect their earnings.

Richard Anderson, MD, chairman/CEO of The Doctors Company, said the response to the survey was “stunning.” While he noted that “we recognized that changes in healthcare delivery were impacting all facets of our members’ practice, the vehement, negative reactions are of real concern.”

He added that in reviewing the complete survey results, “the overarching sentiment is that current legislation will likely have a negative impact on the practice of medicine and will not address the scourge of defensive medicine in America.”

Expressing similar worries was Donald Palmisano, MD, a former president of the American Medical Association and a member of The Doctors Company board of governors. “The physician sentiments expressed in the Future of Health Care Survey are deeply concerning and disheartening,” he said.

Given the shortage of healthcare professionals, Palmisano said, “We are perilously close to a true crisis as newly insured Americans enter the healthcare system and our population continues to age. Unfortunately, we may be facing a shift from a ‘calling,’ which has been the hallmark for generations among physicians, that could threaten the next generation of healthcare professionals.”

Ironically, this negative reflection on healthcare as an occupation comes at a time when, according to the Association of American Medical Colleges, the number of applicants to medical schools is at an all-time high and numerous new medical schools are in various stages of development.

Maybe the survey just arrived on a particularly bad day.

(Jim Stommen, retired executive editor of Medical Device Daily, is a freelance writer focusing on healthcare issues.)