http://www.kevinmd.com/blog/2008/12/decline-of-family-practice-training.html Tue, 14 Feb 2012 21:09:00 +0000 hourly 1 http://www.kevinmd.com/blog/2008/12/decline-of-family-practice-training.html#comment-88915 Carla Tue, 30 Dec 2008 17:57:00 +0000 http://clients.emmense.com/kevinmd/2008/12/the-decline-of-family-practice-training-programs.html#comment-88915 I think this connects with your earlier posts about whether the physician salary inequities lead to lack of student interest in primary care. The bigger issue is the lack of value placed on primary care and how that plays out in the reimbursement system. Hospital systems can't make primary care "pay", so they look for ways to divest themselves of these training programs. So we reap the final harvest of the system as it is currently constructed: nobody to do all the important basic cost saving services and who is trained to be alert to find the occasional zebra. In urban and suburban areas maybe this will all get taken care of by people self referring to various specialists (I can think of numerous patients in my practice that you will really enjoy seeing, specialist friends!)<br/>But the real losers are the low income folks that get good care from residency programs and the inner city and more rural areas that can't support a specialist practice and need well trained family docs to come to their communities. What do those people do when the pipeline dries up?<br/>Its hard to imagine sustainable health care reform that doesn't address this whole mess right up front. I think this connects with your earlier posts about whether the physician salary inequities lead to lack of student interest in primary care. The bigger issue is the lack of value placed on primary care and how that plays out in the reimbursement system. Hospital systems can’t make primary care “pay”, so they look for ways to divest themselves of these training programs. So we reap the final harvest of the system as it is currently constructed: nobody to do all the important basic cost saving services and who is trained to be alert to find the occasional zebra. In urban and suburban areas maybe this will all get taken care of by people self referring to various specialists (I can think of numerous patients in my practice that you will really enjoy seeing, specialist friends!)
But the real losers are the low income folks that get good care from residency programs and the inner city and more rural areas that can’t support a specialist practice and need well trained family docs to come to their communities. What do those people do when the pipeline dries up?
Its hard to imagine sustainable health care reform that doesn’t address this whole mess right up front.

]]> http://www.kevinmd.com/blog/2008/12/decline-of-family-practice-training.html#comment-88914 Lyle Tue, 30 Dec 2008 16:55:00 +0000 http://clients.emmense.com/kevinmd/2008/12/the-decline-of-family-practice-training-programs.html#comment-88914 As a candidate for one of those residency's spots and a life-long Arizonan, I can agree that this is a tremendous blow to primary care in Arizona. These moves show a serious lack of foresight. As a candidate for one of those residency’s spots and a life-long Arizonan, I can agree that this is a tremendous blow to primary care in Arizona. These moves show a serious lack of foresight.

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