Health reform depends on the availability of primary care physicians. Studies have repeatedly shown that systems with a strong primary care foundation rank higher than the United States in cost and quality measures.
Without an appropriate base of generalist doctors, newly insured patients will not be able to access timely care. That’s exactly what is happening in Massachusetts, and this drives patients to the emergency department, further escalating the cost of care.
To quote a certain NFL football coach: “That’s not what we’re looking for.”
Those that think that mid-level providers like nurse practitioners and physician assistants can pick up the slack are sadly mistaken, since these providers see the writing on the wall and want no part of the primary care morass. They’re not stupid.
Today comes a study that reveals that 49 percent of primary care doctors surveyed would consider leaving medicine, with many saying “they are overwhelmed with their practices, not because they have too many patients, but because there’s too much red tape generated from insurance companies and government agencies.”
Furthermore, medical students are not replacing those who leave, with the wide disparity in salary and lifestyle resonating with prospective doctors.
Primary care doctors that do stay in medicine are shifting to concierge, cash-only models, or closing their doors to low payers, with “over a third of those surveyed have closed their practices to Medicaid patients and 12 percent have closed their practices to Medicare patients.”
The biggest losers in the primary care crisis will be the patients.
Internist Robert Centor blames the payment system, wanting to “scrap our dysfunctional system and replace it with one that allows those who love and would love primary care to do their jobs.”
Family physician Doug Farrago doubts that any future reform plan “will ever work unless we make this specialty more palatable. Case closed.”
topics: primary care, reform
