Saturday, April 5, 2008

Universal Healthcare? Not without Primary Care

I've written about the primary care shortage before so I am happy to see the New York Times feature it today.

In Massachusetts they have mandated insurance coverage for everyone (Universal coverage) but the unintended consequence is that these newly insured people cannot find a doctor. There are not enough primary care doctors available and the ones that practice in clinics and offices are full. Taking on more patients just leaves less time for everyone and makes for harried, rushed medicine.

The article is a must read but here are some highlights for you ADD readers.
  • With the aging population, we will need 40% more primary care doctors by 2020
  • Presidential candidates on both sides have stressed the importance of primary care but...
  • There are no plans to overhaul an unfair payment system that undervalues primary care
  • The majority of general practitioners are aging and planning retirement over the next decade
  • President Bush has proposed eliminating $48 million in federal support for primary care training programs
  • New doctors training in primary care have dropped by more than half over the past decade
  • Of those small numbers in training, even fewer (1/16 at Tufts, 4/28 at U Mass) actually plan to practice primary care
Why is this happening? I leave you with an article quote from a busy, successful Family Practice doctor in the medical mecca of Boston. I can assure you, this quote could be duplicated thousands of times across the United States:

"Dr. Atkinson, 45, said she paid herself a salary of $110,000 last year. Her insurance reimbursements often do not cover her costs, she said.

“I calculated that every time I have a Medicare patient it’s like handing them a $20 bill when they leave,” she said. “I never went into medicine to get rich, but I never expected to feel as disrespected as I feel. Where is the incentive for a practice like ours?”"


Barbara K. said...

And even if you have a primary care doctor, it can take months to get an appointment. No wonder emergency rooms are so crowded.

Healthnut said...

You should read the article from LA Times, "An Exodus From Medi-Cal"

Medi-Cal only pays some doctors $24 per visit.,1,2557254,full.story

Anonymous said...

Thanks for this informative NYT article. It spells out very clearly what I have seen happen in the last six plus years in the North Bay of Ca. It is sad and discouraging, but explains the reasons behind this depressing situation well.

JaaJoe said...

Did you see the Bunk study stating 2/3 of doctors in America want National Health Care. The doctors who did this study also conducted one in 2002 and found that the majority of doctors did not want national health care, the problem with this is that the 2 question surveys drastically differ in there 2nd question. I found this article, 60% of Physicians Surveyed Oppose Switching to a National Health Care Plan, It's worth a read.