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- Thread starter mandu_cheeks
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Here are a few of my thoughts. Disclaimer: I am only a scribe for a PCP and submit to the more knowledgeable individuals on here.. And there's quite a few assumptions made in here.
I'm not yet convinced that the problem has much to do with the distribution of physicians, or at least that this is the most significant issue right now. I live in a big city and it was a struggle for me trying to establish care with a PCP in my area. Nobody is accepting new patients. Several of the physicians that I work for are closed to seeing new patients all together. We had a PCP in our practice retire 10 months ago and the hospital has yet to find a PCP to take on her patient panel. We are now fitting in her patients as needed for emergencies as they struggle to find new physicians. And for most PCPs I work for, if you want to schedule a regular appointment and not an emergency we're booked out about 2.5-3 months right now (which is a shortage of a kind). Also, I can't keep track of the number of phone calls my PCP gets from recruiters from Miami, LA, etc. I recognize that rural areas are being hit the hardest with a shortage of PCPs because it is difficult to recruit to these areas, but urban big city areas are also struggling.
Should we hire more midlevels to take on the role of PCPs? That depends on how we want our health system to function. Primary care physicians today are trained in managing diabetes, skin conditions, CHF, chronic kidney disease and more complicated health conditions and comorbities. I worry that hiring more midlevels would just increase the referral rate to specialists to manage these. Paying 100-200$ copay to see a specialist for these seems like an inefficiency and cost burden compared to seeing a PCP which is much, much cheaper.
The concept of hiring foreign physicians doesn't seem to be a very smart long term solution. It is good that patient would get the coverage they need. Also it would be cheap. But the fact that it would be cheap would just further alienate domestic physicians from taking on roles in these areas. Do foreign physicians understand the culture and contexts within the US that might play a key role in someone's health?
If we can find a way to get more amazing and high qualified physicians to go into primary care then our healthcare system will benefit. How we do this might have several parts. We might need to decrease the cost of medical school so that physicians wouldn't feel the pressure to specialize in order to pay off their debt (I don't even know how the cost of medical school is determined in the US). We might need to find a way to decrease the amount of paperwork that is placed on PCPs. PCP reimbursements need to rise undoubtedly. These are all likely naïve concepts to some degree. Right now, hospitalizations induce the most costs in our healthcare system. If we can have more PCPs, then I presume that hospitalizations would reduce and maybe that money could be used to help increase reimbursements of PCPs.
Am I speaking out of my arse? Probably.. I don't even know what I'm doing on this site..
I'm not yet convinced that the problem has much to do with the distribution of physicians, or at least that this is the most significant issue right now. I live in a big city and it was a struggle for me trying to establish care with a PCP in my area. Nobody is accepting new patients. Several of the physicians that I work for are closed to seeing new patients all together. We had a PCP in our practice retire 10 months ago and the hospital has yet to find a PCP to take on her patient panel. We are now fitting in her patients as needed for emergencies as they struggle to find new physicians. And for most PCPs I work for, if you want to schedule a regular appointment and not an emergency we're booked out about 2.5-3 months right now (which is a shortage of a kind). Also, I can't keep track of the number of phone calls my PCP gets from recruiters from Miami, LA, etc. I recognize that rural areas are being hit the hardest with a shortage of PCPs because it is difficult to recruit to these areas, but urban big city areas are also struggling.
Should we hire more midlevels to take on the role of PCPs? That depends on how we want our health system to function. Primary care physicians today are trained in managing diabetes, skin conditions, CHF, chronic kidney disease and more complicated health conditions and comorbities. I worry that hiring more midlevels would just increase the referral rate to specialists to manage these. Paying 100-200$ copay to see a specialist for these seems like an inefficiency and cost burden compared to seeing a PCP which is much, much cheaper.
The concept of hiring foreign physicians doesn't seem to be a very smart long term solution. It is good that patient would get the coverage they need. Also it would be cheap. But the fact that it would be cheap would just further alienate domestic physicians from taking on roles in these areas. Do foreign physicians understand the culture and contexts within the US that might play a key role in someone's health?
If we can find a way to get more amazing and high qualified physicians to go into primary care then our healthcare system will benefit. How we do this might have several parts. We might need to decrease the cost of medical school so that physicians wouldn't feel the pressure to specialize in order to pay off their debt (I don't even know how the cost of medical school is determined in the US). We might need to find a way to decrease the amount of paperwork that is placed on PCPs. PCP reimbursements need to rise undoubtedly. These are all likely naïve concepts to some degree. Right now, hospitalizations induce the most costs in our healthcare system. If we can have more PCPs, then I presume that hospitalizations would reduce and maybe that money could be used to help increase reimbursements of PCPs.
Am I speaking out of my arse? Probably.. I don't even know what I'm doing on this site..
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