Are specialists stealing primary care patients?

February 17, 2007

And are primary care physicians bringing it upon themselves?



Related posts:

  1. When specialists provide primary care, and why patients aren’t complaining
  2. Males = specialists, females = primary care physicians
  3. Should specialists be re-trained as primary care physicians?
  4. Will specialists sacrifice to pay primary care doctors? Are budget-neutral changes the only option?
  5. Should primary care distance themselves from specialists?
  6. Can specialists do primary care?
  7. Should specialists spread the wealth to primary care?


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{ 7 comments }

1 Anonymous February 17, 2007 at 5:16 pm

I became a specialist so that I would NOT have to do primary care. I see more primary care physicians dabbling in things they know too little about than specialists dabbling in primary care.

2 Anonymous February 17, 2007 at 6:44 pm

The fact that this is an issue at all tells me one thing:

there is no doctor shortage.

Good grief people no speicalist would wnat to manage HTN unless they absolutely had no choice because their specialty pool of patients was too small.

If specialists are really taking on primary care, its only because there is a surplus of specialists.

3 Anonymous February 17, 2007 at 11:21 pm

We used to have Oxford health plan at work. I remember a letter they sent to all of us saying that if we regularly see a specialist for some chronic condition, it’s OK with them to make him/her as our PCP.
I haven’t seen a specialist, so I ignored it.

A friend of mine, however, had arthritis. She had a different primary care physician and was happy with him. Then, suddenly her health plan sent her a letter and a new card saying that they consider the specialist she saw for her arthritis her PCP. She wasn’t particularly happy with it, and I am not sure if she objected or not.

So sometimes it is the insurance that does it.

4 Michael Rack, MD February 18, 2007 at 6:58 am

Since all internal medicine specialists are required to do a general medicine residency before their specialty fellowship, it is natural that some would want to keep a hand in primary care.
To eliminate this problem, physicians should be allowed to do fellowship training after only 2 years of general medicine residency.

5 Anonymous February 18, 2007 at 2:16 pm

On the contrary, I would rather more patients go to their PCP and by that the nonsurgical cases would be further weeded out.

6 NoAcuteDistress February 18, 2007 at 6:58 pm

Funny. I am now routinely being sent patients for follow up visits from the ER and Urgent Care centers. And it’s for mindane thinbgs like Otitis Media, Pharyngitis etc.

The typical story is that their PCP’s are too busy to see them,. but somehow these patients get squeezed in on my schedule as a specialist.

There is some perverse incentive at work in primary care with respect to advanced access and maintaining accesss for thier existing panel of patients. The spillover has to go somewhere and increasingly it is the specialist who is taking up the slack.

I can’t speak for other specialists, but I have ZERO desire to see such patients. I don’t think anyone can accuse me of “steaqling” these patients.

I’d say that this situation argues that there is indeed a shortage of PRIMARY CARE physicians in this country.

7 Anonymous February 18, 2007 at 9:31 pm

Exactamundo

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