Saturday, October 04, 20085
Primary care sacrifice
Alexander Sterner writes in an op-ed that no young doctor is entering primary care Internal Medicine. The numbers are this residency program are emblematic of the nationwide trend:
Dr. Sterner also takes a jab at universal health coverage:
Last year, Rush Presbyterian St. Lukes and Loyola University graduated more than 40 physicians trained in Internal Medicine. None will work as traditional primary care doctors. All but 6 chose to complete several more years of training as cardiologists, gastroenterologists, oncologists or nephrologists.This is the first I've read where graduating residents are starting to go directly into boutique practices. Normally, established physicians are the ones who make the transition to concierge care. It's a disturbing that significant money is spent to train these doctors only for them to go to cash-only practices.
Of the six who will practice Internal Medicine, three chose to be "Hospitalists," who deliver care only to hospitalized patients. Three joined "boutique" practices, where they are highly paid to be on 24-hour call for entitled individuals, but do not accept Medicare or private insurance.
Dr. Sterner also takes a jab at universal health coverage:
"Universal Health care" threatens to cause "Universally unavailable Health care" by adding people to the mix, creating competition for appointments, increasing waiting times and shortening visits. Soon, an aged adult will have difficulty getting an appointment with his or her physician of choice.He predicts a future where mid-levels will take over direct patient care, with doctors only in a supervisory role.
Comments
-
Anonymous
These "boutique" opportunities will no doubt come laden with contractual restrictive covenants that will place the new graduate in the subordinate position to his employer for some time to come, perhaps indefinitely. If he gets dissatisfied covering the call of his and his employer's practice, there will always be another new graduate to take his place.
-
Anonymous
Kevin,
-
Steven D. Knope, M.D.
As our politicians have been pontificating about the "morality" of nationalized health insurance, there has been a silent, mass exodus from primary care medicine. No bright young medical student in his/her right mind would opt for a career as an internist in our current system, or even worse, opt for a career in some nationalized health care system run by Washington bureaucrats.
-
Anonymous
ha! the mid levels won't want to do primary care either. what is going to happen then?
-
Anonymous
I'm a graduating primary care resident next summer that is also going into concierge medicine. Maybe I will work a few years in a traditional system just to get my hands more wet, but most likely, I will start up from scratch.
Post a Comment9:04 AM
You're mixing "cash based" and "boutique" practices as if they're synonymous, they're not.
Cash based practices reject third party payers but aren't necessarily for the affluent nor always require an annual fee. Boutique practices often take insurance payments but, of course, get that annual fee from their affluent patients.
11:39 AM
Concierge medicine, which is nothing more than private practice with a twist, is the only rational response for young doctors who want to practice internal medicine. Good for them!
Steven D. Knope, M.D.
Author, Concierge Medicine, A New System to Get the Best Healthlcare." (Praeger, 2008)
www.conciergemedicinemd.com
10:02 AM
10:08 AM
No way I am going to work for the government for peanuts and take crap all day. I would rather not practice medicine than having to even think about "ICD"-codes.
And Kevin is right. There are more coming. I don't know any of my fellow residents that haven't considered concierge in one or the other way.
3:01 AM