Tuesday, January 6, 2009

Primary Care Shortages...

We've talked about MLP utilization, we've discussed hospital bed shortages....but now I think we need to talk about one of the biggest hurdles/problems in american medicine today.

We've discussed various issues with healthcare here, and recently I have been talking about the problems with simply enacting or instituting nationalized healthcare....NOTE, I am not saying that we should not eventually do this, as it is probably eventually needed, BUT, we need to do this slowly.....

Keep in mind that it took TEN years for Japan to re-work their healthcare system and provide nationalized healthcare.....TEN YEARS. And their society is much smaller and more homogenous. Recent estimates I've seen have suggested that it will take close to 20 years for a nationalized health plan to truly be implemented and function well. And it must be a multi faceted approach that addresses other problems as well.

Here's one:

http://www.usatoday.com/news/health/2008-11-18-doctor-shortage_N.htm

Primary care doctors in the United States feel overworked and nearly half plan to either cut back on how many patients they see or quit medicine entirely, according to a survey released on Tuesday.

And 60 percent of 12,000 general practice physicians found they would not recommend medicine as a career.

Eleven percent said they plan to retire and 13 percent said they plan to seek a job that removes them from active patient care. Twenty percent said they will cut back on patients seen and 10 percent plan to move to part-time work.

Now, imagine adding an additional 49 million patients to this system???

And add to that, that a recent survey of 1200 medical students indicated that only, ONLY 2% were planning on entering primary care......2%....we need that to be closer to 30%, at least.

Thoughts?

5 comments:

The Happy Hospitalist said...

As a country, we are screwed unless something drastic changes. We need gorilla change

Michael Halasy said...

I agree, I was at a meeting recently in DC, where this issue was discussed, and there are a lot of people that see primary care being dispensed almost solely by MLP's, with primary care clinics only having one or two MD/DO's to manage the more difficult cases, and provide supervision, and help to the NP's and PA's...

The Happy Hospitalist said...

"More difficult cases"

That's internal medicine.

Michael Halasy said...

Yeah, while I always support PA's, I can't but feel sad that our system has gotten to this point. I also wonder about a new grad PA or NP being virtually on their own in a primary care clinic. It would almost necessitate mandatory PA residency programs I think.

Which by the way, I support.

Motherhood for the Weak said...

Phsyasst--the primary care MLP provider model is exactly why I would like to go back to school for PA or NP.

That and I'm actually interested in primary care.

Cheers
M