More on Primary Care Challenges

As healthcare reform becomes more and more the topic du-year (and next year, and the year after that — a long time, I’m sure) — this one aspect will become more and more of a challenge:  finding a primary care doctor and/or getting an appointment to see one.

In my last post, I cited a great article in last week’s CNN Empowered Patient about how to make a primary care appointment happen, even if you can’t get in to see your doctor right away.  But this post addresses the bigger issue of the lack of primary care doctors.

An article in the LA Times spells it out very clearly.  There just aren’t enough primary care doctors around, and they aren’t being paid enough to keep practices open OR to entice enough medical students to choose primary care for their careers.

If that doesn’t make sense to you, consider this:  if you came out of medical school with, oh, say, $200,000 in education loans / debt that needed to be paid back, and you had your choice between:

  • A.  a job as a primary care physician who was pretty much on call 24/7/365 — or at least close to that — and you made maybe $175,000 a year


  • B.  a job as a specialist who had specific hours (maybe not exactly 9 to 5, but close), and you made maybe $300,000 to a million dollars per year

Which would you choose?

Primary care must be addressed on the front lines of any reform problems.  Massachusetts has showcased this problem quite well.

What are the alternatives?

  1. some states are considering forgiving much of the debt of primary care medical students if they study in that state, then practice in that state
  2. encourage more nurses to become nurse practitioners — an excellent way to deliver primary care
  3. improve reimbursements to primary care doctors (which will drive up consumer costs, too)
  4. others?  do you have suggestions?

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2 thoughts on “More on Primary Care Challenges”

  1. Time is the problem with primary care. Because of lower reimbursements, PCPs need to see more and more patients and spend less time with (and thinking about) each one.

    The result is a high rate of incorrect diagnosis and treatment, unnecessary suffering, and avoidable expense. Not to mention a terrible customer experience.

    It’s well worth it for the government, insurers and even consumers to spend extra money on primary care. The savings in terms of all of these issues would be substantial and well worth the cost.

  2. I’d love to earn $175,000 a year. I’m a family doctor and I’m in the office 7 days a week and I make nowhere near that.

    Thanks for highlighting one of the fundamental problems with our health care system: the lack of primary care medicine.

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Trisha Torrey
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