Smart patients need to establish a relationship with a primary care doctor

Good primary care physicians are becoming harder and harder to find.

You may not have noticed it yet, but I predict that a year from now we’ll find it almost impossible to find primary care doctors who are willing to take on new patients – at least any primary care doctor worth seeing won’t be doing so.

Smart patients and their advocates know that today is the day to be sure they have good relationships established with primary care doctors.

Why? Two major reasons

First comes the fact that medical students spend some time in school, then choose their specialty area.  They contrast the excitement of surgery or saving a heart patient’s life, with the sniffly noses and broken legs of primary care. Then they figure out that as a surgeon or neurosurgeon, it will take them only a handful of years to repay their student loans.  As primary care doctors, who make far less than their specialist counterparts, it will take more like 15 or 20 years to repay those loans.

So what would you choose to do?  So few medical students are choosing primary care these days, and so many are retiring, or leaving their practices, that the numbers of primary care doctors in the United States are horribly low.  Estimates tell us we have between 15,000 and 20,000 TOO FEW primary care doctors in America.

The second reason is not an inside influence, but one that comes from the outside — WE are the reason.  As the numbers of available primary care doctors dwindle, the numbers of people who need their help are climbing.

Baby boomers are aging – and the older we get, the more appointments, tests, procedures and follow up appointments we seem to need. The more we need, the fewer there are for others.

But the biggest hit primary care will take will not be from baby boomers.  It will be from the 30+ million Americans who have not had insurance, but will have access to doctors once healthcare reform kicks in – between now and 2014.

All those new patients – and fewer primary care doctors.  You do the math.

Smart patients know they need to establish a good relationship with a primary care doctor right away, if they don’t already have one.  Make an appointment to get a check-up or to check out some dumb, nagging symptom you’ve tried to ignore.  Then be sure you find a reason to get in to see that primary once or twice a year, otherwise you may end up being dropped from his or her roster of patients.

Smart advocates know that their client-patients need to have that relationship established, and will make sure their clients get that relationship established if it doesn’t already exist.

In fact, that may be what distinguishes you – and makes you the hero advocate – making sure that relationship gets established.  Because once it’s impossible to do, you, the advocate, will get credit for making it happen when it was most important.

•  Learn more about why it’s difficult to get a primary care appointment.

•  Learn more about choosing a new doctor.

Trisha Torrey blogs at AdvoConneciton and is the author of You Bet Your Life! The 10 Mistakes Every Patient Makes (How to Fix Them to Get the Healthcare You Deserve).

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  • Health blog

    Trisha, all well stated. I think a year from now is sooner than it will be really tough in most communities, but not many years.

  • RayC_MD

    Sermonizing to patients and advocates that the “grey wave” of aging Americans is coming, admonishing them to snap up available PCP panel space, and cautioning them to “be sure to find a reason to get in to see that primary once or twice a year” is certainly not a solution. In fact, if anything, this recommendation will actually exacerbate the problem. The last thing we need is to further burden an already strained primary care system with additional unneeded demand from patients who dread “falling off” their PCP’s roster.

    What we need is to start thinking less about the availability of PCP’s, and more about the availability of primary care services.

    • Leo Holm MD

      Right. Primary Care should not serve any “place holder” function. People need access to their own health and not someone who will make the process more occult. Primary Care will never get anywhere by making itself more necessary.

    • Dave

      Yeah, I don’t see falling off because you only go into your PCP once a year. Plus, for most minor things you don’t need to go in. Allergies acting up/sinus congestion? If an OTC decongestant doesn’t work, you can probably get prescribed a nasal steroid over the phone. Just remember the doc isn’t getting paid for that.

      The real solution is to pay PCP’s fairly for their time. Rather than having a bunch of 10-15 minute patient visits, a lot of problems could be solved with a quick 5 minute call/email.

  • soloFP

    One positive aspect of the new heathcare rules is that most insurance plans now offer a free annual physical to patients. This makes it easier than ever for patients to establish care with a primary care doctor. This usually is separate from any deductibles.

    • Apurva Bhatt M.D.

      How is this “free” yearly physical handled if other problems are addressed? I often get people who book a “physical” but really just want to address a bunch of unrelated symptoms that prevents any meningful preventative visit. Often, they’re aghast at my suggestion that such an encounter doesn’t really qualify as a “physical”. Unfortunately, I see this problem only getting worse.

  • soloFP

    The general physical can include a laundry list of concerns. Technically you can bill both an physican and potential an E&M code. The difficulty becomes it is no longer “free,” and patients gets upset if they expect the free physical and get charged something toward their copay or deductible. A solution would be to book another visit for new concerns that are not part of the physical or need additional time.

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