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The Dangers of the Decrease In Primary Care Physicians

Posted Jul 21st, 2008 by Patient Assistance Team
Ask anyone who has recently tried to find a primary care physician (PCP) how much trouble they have had and you will most likely hear what sounds like a bad joke. The number of PCP's are continuing to dwindle as time goes on due to many factors, leaving everyone hurting because of it. The increase in signs reading “no longer accepting new patients” is easily one of the most discouraging aspects of the United States current health care and economic situation.

Economic factors don't just effect patients, they effect physicians as well. So when the average medical student graduates with over $100,000 in debt, it is hard to conceive how one would be willing to become a PCP when they can make double the salary as a radiologist, anesthesiologist, or pathologist. Couple that with the fact that PCP carries with it very low prestige and it's fair share of paperwork hassle and it becomes very clear why PCP's are becoming fewer and far between.

But not only are fewer medical students becoming PCP's, an American Board of Internal Medicine (ABIM) study shows that 21% of general internists are no longer practicing in that field within 10 years of their initial board certification.

With a decline of this magnitude, it is no wonder that hospitals are not seeking the subsidies required to increase their primary care practices and are instead simply no longer accepting new patients. Massachusetts General Hospital and University of California San Francisco Medical Center are two large examples of hospitals going this route.

On the patient side, this shift away from primary care can be disastrous. In a country with over 47 million uninsured Americans are costing the tax payers billions of dollars in medical fees that could be avoided with preventative care, there are becoming fewer places to seek that care than ever before. With a majority of the health care reform plans proposed calling for a substantial increase in preventative treatment, this poses a true problem.

What is even worse is that we are seeing the remaining PCP's become increasingly selective in which patients they will accept. That means that anything from Medicare and Medicaid to state funded health care plans such as those offered in Massachusetts are not necessarily accepted by any PCP within a patients area. You will still receive the benefit of those programs when you visit a hospitals emergency room or visit their specialist, and that essentially guarantees you quality care, considering that is where a majority of the PCP's have shifted to. The demand is so high for a PCP that they have the ability to choose who they see and what insurance they carry.

So how can this possibly get resolved in a system where the goal is for the patient to pay as little as possible, yet the quality of care is expected to continue to rise? Dr. Bob Watcher of The-Hospitalist.org stated that it will take at least the following three steps to fix this problem:

1.Congressmen will need to be unable to find a PCP for themselves or their parents;
2.All the primary care fields will need to band together and lobby with a single voice, rather than as general internists versus family physicians.
3.Managed care will be resurrected, in some new garb, to deal with healthcare inflation.

While the results of this movement increase the quality of care one would receive in a hospital, the lack of preventative treatment and the treatment of chronic conditions significantly hinders the economic and health related progress that the United States is so desperately trying to improve. While many would prefer to see a PCP and preferably one they are familiar with, it is important to still maintain your health at all times, especially in our country's current situation. Please take advantage of our state by state listings of all community clinics and free clinics that are open to patients in need of a physician.