A Crisis for Family Medicine? Number of Primary Care Physicians Isn't Keeping Pace with a Growing Need for Them
Batteh-Freiha, Joy, The Florida Times Union
Byline: JOY BATTEH-FREIHA
Most students enrolled in medical school today have never even heard of Marcus Welby, the beloved, ever-caring, attentive television doctor.
"Marcus Welby, M.D.," which aired from 1969 through 1976, was set in a busy suburban general practitioner's office, with the older mentor physician working alongside his younger counterpart. Interaction between the family physician and his patients was reminiscent of a time when life was less hectic, a time when there were enough primary care physicians to meet the nation's health care needs.
"Most medical students enter medical school today believing in that Marcus Welby, M.D., persona," said Tim Davlantes, a family physician with Mayo Clinic Jacksonville and president of the Florida Academy of Family Physicians. "They may not be familiar with the TV series, but they care deeply for people and truly want to help ease their pain. That's the reason why most of them go to medical school in the first place."
Primary care and family care physicians, who must complete a three-year residency program after graduating from medical school, treat and diagnose 90 percent of all patient problems, according to the academy. Because of their extensive training, family physicians are qualified to treat most ailments for everyone from newborns to seniors.
But the number of family physicians has been steadily decreasing during the past 10 years, and a large percentage of the doctors now specializing in family medicine are over 50. This comes at a time when demand for their services is on the rise. William Hazel, an American Medical Association board member, called the problem "major" in a recent news release and predicted a shortage of 35,000 to 40,000 primary care physicians by 2025.
There are about 83,000 practicing family medicine physicians in the United States, according to the AMA. But a 2006 study by the American Academy of Family Physicians concluded that the United States will need more than 139,000 family physicians by 2020, not only to treat a growing population of seniors whose needs increase with age, but to provide important preventive health care, which in the long run saves on health care costs by lowering emergency room visits and some hospitalizations.
"The decrease in practicing primary care physicians and the alarming dearth of medical students planning to pursue primary care is a problem that cannot be ignored," Hazel said.
During its 2008 Interim Meeting last November, the AMA vowed to address the barriers contributing to the nationwide decline of primary care physicians, citing medical student debt, low Medicare reimbursements, recruitment and training among other issues.
According to the academy, primary care physicians are the lowest paid of the medical specialties and typically receive low reimbursements, juggle hectic schedules and are burdened with endless paperwork.
Davlantes said decreased insurance reimbursements and student loan repayments are two of the biggest issues facing primary care physicians.
"When Medicare does not reimburse the costs of many primary care procedures, these physicians are left with paying for these procedures out-of-pocket," explained Davlantes. "This can be a hardship, especially when you have a physician coming out of medical school with approximately $150,000 in student loans and not getting reimbursed for some routine procedures. The economics don't add up."
Family medicine physician Amber Isley agreed, but said another important reason for the shortages of primary care physicians is the fact that many are overextended with patients and paperwork.
"Out of all the specialties in medicine, family practice is probably the most demanding of its physicians, and the least paid of the specialities" said Isley, who is with Mayo Clinic Jacksonville. "Not only do we treat the whole patient, but we must always be on top of and up-to-date on the latest information for treating conditions such as diabetes, hypertension and breast health, to name a few. …