Is there really a physician shortage?

Or is it a declining number of doctors refusing the accept certain insurances, or subject themselves to the abuses of the health system?

Emergency physician WhiteCoat cites a number of stories where patients are not receiving timely access to care.

In one, which I alluded to last week, parents unable to find pediatricians in California willing to accept Medi-Cal. As he wryly observes, “the fact [is] that universal coverage doesn’t mean much if no one takes your insurance.”

Massachusetts can relate. Just ask anyone in that state looking for a new primary care doctor.

Across the country in Florida, a similar situation is being seen, this time with specialist care in emergency departments. EMTALA’s unfunded mandate forces on-call specialists to treat all comers, “even though many patients needing emergency services will never pay their bill and can sue for millions of dollars if the care they receive is not deemed adequate.”

The result is an increasing number of specialists refusing to cover the emergency department, leaving patients without timely access to a neurosurgeon, otolaryngologist and the like.

In both these cases, the problem wasn’t that doctors weren’t available. It’s the result of those trying to legislate care from above without having an adequate knowledge of the realities on the ground.