PRIMARY CARE; Disappearing Docs

The Florida Times Union, June 19, 2009 | Go to article overview
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PRIMARY CARE; Disappearing Docs


They're called primary care doctors, but they are treated like they are secondary.

The key to bringing down health care costs and improving quality of life is to have healthier habits and avoid the lifestyles that often lead to chronic disease.

That is why the American Medical Association is emphasizing improved nutrition and exercise and warning against the use of tobacco and alcohol in excess.

Patients need more time with their primary doctors.

Patients need an advocate when navigating the confusing health care system, but primary doctors already have their hands full with tons of bureaucratic red tape.

During a 90-minute discussion with small business owners, this major issue dominated.

As local consultant Brian Klepper said, about 70 percent of American physicians are specialists. In other industrialized countries, 70 percent of physicians handle primary care.

SYSTEM IS DYSFUNCTIONAL

The system does not reward doctors for primary care, either through payment or quality of life.

One primary care doctor told the Times-Union Wednesday that he advised his children not to enter that field; a depressing thought.

Now the nation is finding a shortage of physicians to perform primary care, too few primary care residency programs and a reimbursement system that seems to shortchange primary care.

Procedures are reimbursed at high levels, not visits. That pushes doctors away from primary care and into specialties.

Especially when medical school loans reach the stratosphere, what is a physician supposed to do?

The New York Times reports that new doctors typically owe more than $140,000 in loans when they graduate.

Now there are proposals to increase the Medicare reimbursement rates for primary physicians.

No insult to the specialists, but the job of a good generalist is just as demanding - perhaps more so.

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