Comments on: Should specialists be re-trained as primary care physicians?

By: Anonymous

Anonymous — Tue, 05 May 2009 23:20:00 +0000

"meet with strong resistance from those docs?"

Only if you try to force them. It isn't a dictatorship yet.

Anyway, legally, there is no need to retrain anyway and nothing in most if not all states to stop them from just doing it tomorrow other than an awareness of their own limitations and the fact that they just don't want to.

Most, I expect, would try to open a subway shop instead.

By: roger

roger — Tue, 05 May 2009 17:37:00 +0000

Not only not a joke, this is already happening in China.

http://www.med.wisc.edu/news/item.php?id=4427
” Chinese officials are now placing greater emphasis on retraining its doctors rather than developing new residencies. ‘They want to retool people already working in the community,’ says Kushner. “

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2099684

“At the end of 1999, the Chinese Ministry of Health set ambitious targets for the development of family medicine education over the next 10 years. This included, by 2002, to retrain 1000 GPs trainers from other specialties.”

Not saying that this is the answer for the US, but I’m sure that it will seriously be considered, as long as payment reform happens (clearly not a given).

By: Anonymous

Anonymous — Tue, 05 May 2009 03:53:00 +0000

Frank…. and how hard is it to shove a camera up a guy’s ass or read an EKG?

By: Mike

Mike — Tue, 05 May 2009 01:54:00 +0000

What is Frank Drackman saying? Is it sarcasm? Honestly I can’t tell.

By: Anonymous

Anonymous — Mon, 04 May 2009 21:26:00 +0000

I don’t think this is as amusing as it seems. If specialists’ reimbursements drop drastically, and/or the # of available patients for them to do procedures on goes away, what recourse will they have? Don’t think that things will continue the way they have been; it’s ostrich-like thinking.

retiredpath

By: Anonymous

Anonymous — Mon, 04 May 2009 17:21:00 +0000

Funniest thing I’ve read in awhile. Joe is going to ask people, that generally have done a longer residency and had more training of which they have had to compete tooth and nail to get, to uproot their family amd sell their homes go back to residency. They can then graduate and restart their lives. Gee whiz, where do you get to sign up for that?
You know what I think? There are too many health care consulting firms and people like Joe Paduda need to be sent back to school to be a botanist or airplane mechanic, since we have way too many people making money off what they think healhcare should be. Most haven’t ever done one important thing when it comes to healthcare, like I don’t know, TAKE CARE OF PATIENTS, but they sure have an opinion and sure make money off of it.

By: Carla Kakutani MD

Carla Kakutani MD — Mon, 04 May 2009 16:12:00 +0000

With the way things are currently set up, what specialists would want to do this? Also, the training would have to be carefully planned out. According to a study in the Journal of Family Practice, 1998, having a primary care physician as your personal physician led to 33% lower cost of care and better outcomes compared to using a specialist physician. It would mean teaching the thought process behind managing the undifferentiated patient, handling the interplay of mental health and physical complaints, and learning the myriad health maintenence recommendations, among other things. Without the right training you would have “primary care” without the bang for the buck real primary care provides.

By: Lizzie

Lizzie — Mon, 04 May 2009 15:35:00 +0000

When I lived in NYC several years ago I would see my hematologist for matters I would normally have seen my PCP. This was at his suggestion when I asked for a PCP referral. (I had recently moved to NYC one year post-lymphoma treatment. Doc saw me for follow up care only). Not sure it would work these days – it was 22 years ago and I suppose a lot has changed in caseloads since then.

I was young and otherwise healthy and only needed PCP care twice in 10 years. The only thing is, I never felt I was getting the full picture of my health – just the view from his perspective. Being otherwise healthy I suppose I was an easy patient to manage – but what about more complex, subtle things?

By: Frank Drackman

Frank Drackman — Mon, 04 May 2009 15:14:00 +0000

Really, how hard is it to order a Mammogram, write for a Z-pack or throw some metformin at a Type 2 diabetic…

By: Anonymous

Anonymous — Mon, 04 May 2009 14:08:00 +0000

I am a family practitioner.
Only an idiot would go from being a specialist to primary care.