Comments on: The physician shortage http://www.kevinmd.com/blog/2007/07/physician-shortage.html Tue, 14 Feb 2012 11:46:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2007/07/physician-shortage.html#comment-77551 Anonymous Wed, 11 Jul 2007 18:46:00 +0000 http://clients.emmense.com/kevinmd/2007/07/the-physician-shortage.html#comment-77551 In fairness, there are few insurance contracts, at least in my area, where you are expected to act as a "gatekeeper" in any way.<br/><br/>Medicaid would love to shove one down our throats, but the doctors in our area overwhelmingly refuse to sign.<br/><br/>Actually, as HSA's take off, I wonder if there will be more call for primary care docs who offer more under one roof. Someone holding a HSA might appreciate the value of not having to see the cardiologist's nurse for blood pressure, the pulmonologist's nurse for asthma, the endocrinologist's nurse for diabetes, pay the specialist fee and not see the specialist, when one decently trained FP physician could manage it all, and for less. In fairness, there are few insurance contracts, at least in my area, where you are expected to act as a “gatekeeper” in any way.

Medicaid would love to shove one down our throats, but the doctors in our area overwhelmingly refuse to sign.

Actually, as HSA’s take off, I wonder if there will be more call for primary care docs who offer more under one roof. Someone holding a HSA might appreciate the value of not having to see the cardiologist’s nurse for blood pressure, the pulmonologist’s nurse for asthma, the endocrinologist’s nurse for diabetes, pay the specialist fee and not see the specialist, when one decently trained FP physician could manage it all, and for less.

]]> By: Happymanhttp://www.kevinmd.com/blog/2007/07/physician-shortage.html#comment-77549 Happyman Wed, 11 Jul 2007 18:09:00 +0000 http://clients.emmense.com/kevinmd/2007/07/the-physician-shortage.html#comment-77549 being the "gatekeeper" is a losing proposition in every way for a doctor:<br/><br/>1-makes patients (wrongly) feel you have financial gain from withholding specialty referrals<br/><br/>2-puts the onus on the PCP to see patients without notice or appointment for even the most minor things<br/><br/>3-produces tons of non-reimbursible paperwork<br/><br/>4-gives every specialist, tech, nurse & ancillary staff a scapegoat absolving them of any responsibility for a bad outcome<br/><br/>5- JUST ISN'T WORTH IT AT ALL<br/><br/>i'm convinced - primary care is dead. being the “gatekeeper” is a losing proposition in every way for a doctor:

1-makes patients (wrongly) feel you have financial gain from withholding specialty referrals

2-puts the onus on the PCP to see patients without notice or appointment for even the most minor things

3-produces tons of non-reimbursible paperwork

4-gives every specialist, tech, nurse & ancillary staff a scapegoat absolving them of any responsibility for a bad outcome

5- JUST ISN’T WORTH IT AT ALL

i’m convinced – primary care is dead.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/07/physician-shortage.html#comment-77545 Anonymous Wed, 11 Jul 2007 17:16:00 +0000 http://clients.emmense.com/kevinmd/2007/07/the-physician-shortage.html#comment-77545 I never could understand why primary care docs were so anxious to call themselves "gatekeepers".<br/><br/>Why not get it over with and go for "Nazi Prison Guard" or something.<br/><br/>And I am in primary care, by the way.<br/><br/>Agree with urologist. When there is enough of a shortage and IF there is value to primary care, pay will increase accordingly.<br/><br/>Personally, I keep value by performing as many services as I can do under one roof. I keep no gates, never did. I never could understand why primary care docs were so anxious to call themselves “gatekeepers”.

Why not get it over with and go for “Nazi Prison Guard” or something.

And I am in primary care, by the way.

Agree with urologist. When there is enough of a shortage and IF there is value to primary care, pay will increase accordingly.

Personally, I keep value by performing as many services as I can do under one roof. I keep no gates, never did.

]]> By: Matthewhttp://www.kevinmd.com/blog/2007/07/physician-shortage.html#comment-77542 Matthew Wed, 11 Jul 2007 16:07:00 +0000 http://clients.emmense.com/kevinmd/2007/07/the-physician-shortage.html#comment-77542 Clearly what we need is more government intervention. We need Hillary Clinton to proscribe the numbers of each specialty allowed, where they can work, how much they make and the racial distribution of physicians in various specialties.<br/><br/>Hillarycare! Yeah! Clearly what we need is more government intervention. We need Hillary Clinton to proscribe the numbers of each specialty allowed, where they can work, how much they make and the racial distribution of physicians in various specialties.

Hillarycare! Yeah!

]]> By: The Independent Urologisthttp://www.kevinmd.com/blog/2007/07/physician-shortage.html#comment-77539 The Independent Urologist Wed, 11 Jul 2007 13:44:00 +0000 http://clients.emmense.com/kevinmd/2007/07/the-physician-shortage.html#comment-77539 When I was a medical student in the early 1990's, they were saying the exact same thing; predicting huge primary care shortages and geographic disparities. Many people were encouraged to become PCPs and family physicians with the lure of "gate keeper" status. What happened was that the numbers of PCPs swelled and pay fell. When the PCP's are REALLY at a shortage, I suspect that supply and demand will take over, and their pay will increase. When I was a medical student in the early 1990′s, they were saying the exact same thing; predicting huge primary care shortages and geographic disparities. Many people were encouraged to become PCPs and family physicians with the lure of “gate keeper” status. What happened was that the numbers of PCPs swelled and pay fell. When the PCP’s are REALLY at a shortage, I suspect that supply and demand will take over, and their pay will increase.

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