Primary-Care Doctor Shortage May Undermine Health Care Reform Efforts

Washington Post:

As the debate on overhauling the nation's health-care system exploded into partisan squabbling this week, virtually everyone still agreed on one point: There are not enough primary-care doctors to meet current needs, and providing health insurance to 46 million more people would threaten to overwhelm the system.

Read the whole story: Washington Post

Comments

[smileatfear]

There are many people who would love to go to medical school, would be good drs, but get discouraged because they don't have the money. Debt forgiveness, better pay for interns, more scholerships all would go a long way towards getting more drs. into primary care.

Also, there should be more naturopathic colleges. Naturopaths are, by training, generalists. There are only a handful of naturopathic colleges right now but that could be remedied. My naturopath has provided wonderful primary care for my family and me for several years. He's much better at diagnosing problems than any MD I've ever been to and he has a lot more options to pharmaceuticals. Right now most insurance companies won't pay for naturopathic care but a government plan could fix that, also.

[Mugzi]

Actually, I prefer to see the physician's assistant. She writes perscriptions and she talks to me at length about what is going on...more than the 5 min when I see the dr.

[TeeLolly]

Presently, it is the insurance industry that won't fairly compensate primary care doctors (preferring to pay tens of millions of dollars per year to each of its top executives instead). A public plan could fix the problem by paying primary care doctors instead of the insurers whose only job is to keep the rest of us from getting the care they are supposed to pay for ...

[Mikesacola]

If the combined resources of the veterans, defense, education and HHS departments built and opened NEW med schools those schools could train enough talent to close the deficit. For starters all
former active duty Army medics and Navy corpsmen should be identified and given first crack at enrolling. Provide "pre" training where needed. These folks are the best of the best when it comes to dedication to their patients. Many have been wounded in action giving care under the most extreme deadly conditions possible, and have saved countless thousands of lives. They deserve a special program and would put the money-grubbers to shame.

[epiphany1234]

And what about a public med school open to all levels of society to produce first quality PC's to work within the public system?

A national med school would suffice if it can't get up and running on the local level. They can bring in the best teachers from all over the world if necessary.­....Cubans­, Canadians, French...w­hoever's willing to work within the public system if US citizens are not.

Anything is "possible", and it's time we started to think outside the confines of the status quo that has failed us for decades.

[LorettaSingbiel]

the report warns, "if the nation moves rapidly towards universal health coverage" -- which would be likely to increase demand for primary care and reduce immediate access to specialists -- the shortages "may be even more severe."

So it's every man for himself then?

How come you "conservative christians" ... you "right-to-life" republicans ... fight SO HARD for a frozen embryo or fetus ... and not for LIFESAVING HEALTHCARE for ALL AMERICANS?

Give the GREEDY doctors a LECTURE reminding them to honor their Hippocratic Oath "to keep the good of the PATIENTS as their highest priority".

Get rid of the GREEDY insurance companies who honor their HYPOCRITIC Oath to keep the good of the PROFITS as their highest priority!!!

Give MORE monetary incentives toward those doctors pursuing primary care. Give monetary incentives toward the training of ALL healthcare providers.

And give EVERYONE accessibility to AFFORDABLE, QUALITY HEALTHCARE in our "civilized" country!
NO MORE EXCUSES!!! GET 'ER DONE ...

[Clarabell]

"Give the GREEDY doctors a LECTURE reminding them to honor their Hippocratic Oath "to keep the good of the PATIENTS as their highest priority".­" Do you think that my daughter, who is now an MD/PHd (after 11 years of grad and medical school, plus 4 years of college) is greedy? She just finished her intern year, working 80 to 100 hrs a week for $45,000 a year. She still has three more years to go as a resident before she can make a decent living. THIS IS GREED???

[CJWebber]

He's not talking about the pay of residents.

[mydwyf]

My daughter is midway through that cycle. Some of her female classmates are literally selling their eggs online to help pay their way. That is so very disturbing to me.

[droftim]

This article fails to mention that this is yet another legacy of the accidental origins of health coverage in this country.

After WWII, when the for-profit insurers were holding meetings with physicians to set up these programs, guess who had the flexibility to take off to attend a meeting on a weekday afternoon? While General Practitioners were treating the everyday ills of their patients, surgeons and other specialists could just close their offices for the day. Medicare, which was purposely designed to protect the status quo as far as doctors was concerned, cast all the inequities in stone. Once again, it's the for-profit insurance that has defined our national health policy.

Suppy is not hard to fix: If we had a program that forgave a percentage of a doctors student loans for every year that he worked as a primary physician, I'm sure the supply would increase. It could work similar to the one that forgives loans to teachers who work in certain areas. Retention will be harder unless the payment systems change value the things primary physcians do.

[quindy]

Health care reform could get rid of disparities in the payments. If primary care doctors are paid on the level of specialists (or just little bit less) than more doctors would go into primary care. Not everyone wants to be a specialist. The problem with primary care is that if they serve rural population most people don't have insurance and so the doctors don't get paid. In a small town in Maine where we frequently visit, the local doctors change with the season. There are times when no doctor is there at all. People are mostly uninsured (thanks to the exorbitant premiums or lack of work) and doctors cannot keep their practices going with uninsured population. Insuring people would mean steady income for primary care doctors too.

[Chaimirija]

that is why I don't get the doctors who are against single payer...th­e canadian doctors just dubmit the bill and then they get paid. case closed. and everyone they see is covered...

[Clarabell]

I'm for single payer, but if you were to see how much a doctor gets for a medicare patient, you would be very surprised at how little it it. The plumbers we hire can get more.

[epiphany1234]

If there's a shortage, well that's the justfication for governement and academia to oil up the ways and means to get more PC's through med school. This is an endeavor the AMA should be putting their know-how to the grindstone to get accomplish­ed....fina­ncing the education of qualified people to become doctors. Don't tell me they don't have the money and the knowledge to do this.

I think of all the genius minds wasting away in inner cities who would make fabulous doctors if they had the means to acquire the education and training (as people can do in other countries).

Getting an MD shouldn't be put out of the financial reach of so many millions of qualified Americans.

[Chaimirija]

do not forget that the ama has been behind keeping the supply of doctors low....the­y are the most powerful labor union on earth

[Chaimirija]

Also, they can use extenders, PA's and NP's...btw­, if they can bail out the banks, they can give scholarships to future students

[Chaimirija]

kasinca is right.

[fcsakes]

They probably got tired of filling out the mountains of paperwork that are required by for-profit health care in order to justify their practice.

[Chaimirija]

truth be told, they don't make anywhere near as much as specialists

[kasinca]

And that is the result of a greedy money mongering healthcare system based on volume instead of quality. The whole system sucks. My GP and I talked about it last year. He became a MDVIP which limits his practice to 600 because he said the healthcare companies were telling him how to practice. He was very critical of the current situation.

[smileatfear]

Some doctors won't even take insurance anymore. It costs too much to keep the large staff they needed so they just stopped taking insurance and dropped their prices.

[Whale]

60 days to see a doctor? I wonder how long it takes, on average, in Canada. This kind of blows holes in the argument that single-payer will mean much longer waits to see a doctor ( what? 240 days? ). The implication has always been that Canadians, etc can't see a doctor without a long wait where USA citizens see the doctor immediately.

This doesn't even begin to address the issue of insurance companies denying care (so much for the "bureaucrats between you and your doctor).

[Chaimirija]

they wanted to imcrease the number of primary care physicians in canada and they did it..at's about 50%

seems to me the lobby's are just finding any and all reasons to stop reform...c­an you blame them? look how much money they are making. They are being too greedy now though

[kasinca]

You believe in the easter bunny too? Get real. Don't buy the lies of the healthcare companies. They are not looking out for you.

[marijam]

Health care reform will encourage more people to go into medicine.

[kasinca]

This is a non-story. Pass the bill, include provisions to encourage more primary care physicians. The current greed healthcare system encourages otherwise.