Comments on: Welcome USA Today readers

By: Anonymous

Anonymous — Fri, 14 Mar 2008 21:53:00 +0000

There are other underpaid, over-educated professions. Son #1, BS Brown Univ. PhD Virginia Tech (in a physical science) at age 33 is in his 5th year as an asst. prof. at a large univ in VA earning $52,500/year. Son #2, AB Harvard, PhD Columbia (in humanities)age 30, has just been offered a job in NYC paying $45,000/year! Count your blessings!

By: H G Stern, LUTCF, CBC

H G Stern, LUTCF, CBC — Fri, 14 Mar 2008 01:59:00 +0000

Mazel Tov, Kevin!

Just had a chance to read today's paper, and saw your op-ed.

Well done, and well-deserved!

By: Paul Levy

Paul Levy — Thu, 13 Mar 2008 19:57:00 +0000

Well stated, Kevin!

By: Anonymous

Anonymous — Thu, 13 Mar 2008 18:45:00 +0000

Dr. Pho.
Thank you, you have done a great job, it is concise and to the point. I am a CPA and have been working with phyiscians for 20 years. Only now are they really worying. Primary care (peds, general med, family prx, and Internal medicine) physicians are all worried about their financial welfare. My father, earned, 30 years ago, more than what pediatricians are being paid today. Primary care doctors keep patients out of the emergency rooms which are already overcrowded and away from the specialist until needed. The impending collapse of the primary care physician network would be a catastrophic event that would cripple our entire healthcare system. They ARE the backbone of the system. The next step is for the primary care physicians to band together and form larger groups or die. There needs to be some cohesive action to start contacting their congressmen and other lawmakers to simply state that they are 'Angry as *&^% and are not going to take it anymore." Most primary care physicians are in medicine for the love of medicine, not the financial renumeration, but there will come a point where they are just not paid enough. I plead with all physicians to start yelling and screaming to save their jobs, their livelihood and to save a medical system which, when it works, will keep our overall medical costs down. Currently, 3 insurance companies (BCBS, UHC and AETNA) insure 75% of the insured lives in the US. At some point it must be deregulated. The profits of those three companies is sufficient alter the healthcare for every citizen in this country and permit everyone to have full healthcare benfits.

I urge the physicians to take action NOW, befor its too late.

JMiller, Arizona

By: Davis Liu, MD

Davis Liu, MD — Thu, 13 Mar 2008 17:10:00 +0000

Congratulations on your op-ed piece. As a practicing primary care doctor, I would add another issue for consideration - does primary care have the support systems necessary to make the practice sustainable for the long-term?

I am fortunate enough to work in a medical group that is heavily wired in information technology. Information technology helps me take better care of my patients by minimzing medical errors with prescribing medications electronically, decrease the amount of time searching for lab and xray results, and reminds me with prompts so I remember what preventive tests are due for patients in the office as well as those I haven't seen over a couple of years to keep them all healthy.

Even if reform compensates primary care doctors for thinking and coordinating care, we need to make caring for patients who are living longer with more chronic illnesses easier than it currently is. Information technology makes many other aspects of our lives more manageable and simple. Installing, implementing, and adopting information technology for medical care must be part of the conversation so that primary care continues to be attractive to doctors practicing today and those seeking it as a future career.

By: Anonymous

Anonymous — Thu, 13 Mar 2008 16:38:00 +0000

Congratulations on getting your letter published. As a specialist who depends on my community of primary care doctors to assist me in caring for my patients, I agree with your assessment of the primary care access crisis that is to come (and is really here, but probably not yet in force.)

I fear the public will not see these trends as a problem until it becomes a problem for many of them. When retirees can’t get a doctor who will see them for their Medicare restricted payments, and when family gets tapped to support their elderly members who have to pay out of plan for care. The problem, however, is that a fix, even when it becomes widely understood to be necessary, will be slow in coming. You won’t make a crop of primary care doctors overnight. That will take several years to undo the effects of the present exodus and graduate preference toward specialization.

By: Anonymous

Anonymous — Thu, 13 Mar 2008 16:25:00 +0000

Kevin:
I am a regular reader of your blog, and your commentary on the consequences of the demise of primary makes sense. But keep in mind that the specialists, especially the surgical specialists (such as ophthalmology, my specialty) simply will not work as surgeons fo 150K per year. They have an expectation to make more than that, as they do now. In fact, they feel they are already underpaid, to take on the stress and risk of modern surgery. Re-apportioning reimbursement from a shrinking pie will cause huge numbers of surgeons to opt out of Medicare (Ophthalmologists will not do $400 cataract surgery.) Then there will be a different kind of crisis. People will have to pay cash for specialty care.
PS an EYEMD

By: Skeyepremd

Skeyepremd — Thu, 13 Mar 2008 14:45:00 +0000

Great piece. As a pre-med student, I am currently weighing the ethical pull to serve where it is most needed (primary care), as opposed to the practical pull to go where I can make a decent living and pay off the mountain of debt I will accrue (specialist). Let’s hope that when I reach that fork in the road, the more ethical choice will be the easier path to take.

By: Anonymous

Anonymous — Thu, 13 Mar 2008 14:25:00 +0000

hey i heard you on npr today as well. congrats.

By: WhiteCoat

WhiteCoat — Thu, 13 Mar 2008 13:07:00 +0000

Good work on the Op-Ed piece. Concise and makes a lot of good points.
Now if only the politicians would listen …