PCP shortage

Started by gmcguitar4
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gmcguitar4

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So everybody is aware there is and will continue to be a shortage of PCP physicians in the US. I can definitely see myself becoming a PCP just by my personality and value of a life/work balance. But, I also consider being one to assist in the current shortage. Even if I am more interested in other specialties do you think its a legitimate to become a PCP to help the current problem in the United States over my own interests? Would you consider being a PCP to do the same thing? I understand everyone has their own goals and interests but I am just curious how you all feel about this and if it would make an impact on your decision to enter a certain field.
 
gmcguitar4 said:
So everybody is aware there is and will continue to be a shortage of PCP physicians in the US. I can definitely see myself becoming a PCP just by my personality and value of a life/work balance. But, I also consider being one to assist in the current shortage. Even if I am more interested in other specialties do you think its a legitimate to become a PCP to help the current problem in the United States over my own interests? Would you consider being a PCP to do the same thing? I understand everyone has their own goals and interests but I am just curious how you all feel about this and if it would make an impact on your decision to enter a certain field.
Click to expand...

Are you saying that PCP's work less than other physicians where mentioning the life/work balance?
 
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Most PCP's I know work longer hours than most other physicians. That's a real broad statement, but if there's a shortage of preexisting PCP's, shouldn't there be a higher volume of patients per PCP?

To get back at your question, wanting to enter primary care because there is an immediate need for PCP's is a valid and compelling reason in my opinion. Just make sure you have other reasons as well.
 
I am sure it depends on on a doctor-to-doctor basis because there are a ton of other factors that can go into it...but don't stray from the question!
 
PeterPesto said:
Most PCP's I know work longer hours than most other physicians. That's a real broad statement, but if there's a shortage of preexisting PCP's, shouldn't there be a higher volume of patients per PCP?
Click to expand...

The cardiologists and surgeons at the hospital I work at definitely put in a ton of time, they are there all day/night..I have asked some PCP's I know and they say its more the # of patients per hour that is the problem. To keep the hours from going crazy they might try to cram 15 patients into an hour. This is especially significant and is a direct result of medicaid reimbursements.
 
Increase reimbursements and you'll get more PCPs.

Too bad that's never going to happen.
 
gmcguitar4 said:
The cardiologists and surgeons at the hospital I work at definitely put in a ton of time, they are there all day/night..I have asked some PCP's I know and they say its more the # of patients per hour that is the problem. To keep the hours from going crazy they might try to cram 15 patients into an hour. This is especially significant and is a direct result of medicaid reimbursements.
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That's their choice if they want to shoehorn 15 patients in an hour, which seems utterly crazy to me. Also, it's their choice if they want to take on patients on medicaid in a private setting. Ultimately, like you said, it depends on the doctor and the setting.

To answer your question, I think a PCP has to be a people person first and foremost.
 
gmcguitar4 said:
Even if I am more interested in other specialties do you think its a legitimate to become a PCP to help the current problem in the United States over my own interests?
Click to expand...

No.

It's a great sentiment that you'd want to be a PCP because of a nationwide shortage, even if you're more interested in something else. However, keep in mind that being a PCP is hard work. Yes, the lifestyle is somewhat better, and there's more flexibility than in some other specialties, but the hours that you work are often chock full of difficult patients, trying to keep a grasp on a wide variety of problems, and juggling tons of paperwork. If you don't really enjoy it, you'll be miserable at work, and then that's not being fair to yourself OR your patients.

Being a PCP is a good fit for me. It has some small procedures, which I like, a fairly decent lifestyle, which I also like, and a variety of patients, which I need. I've never had a subspecialty rotation which I could see myself doing for the long term; I get bored by seeing the same type of patients over and over again. But that's my personality, that's not everyone. Don't force yourself into something that you might not really enjoy, just because you're feeling guilted into filling a shortage.
 
gmcguitar4 said:
The cardiologists and surgeons at the hospital I work at definitely put in a ton of time, they are there all day/night..I have asked some PCP's I know and they say its more the # of patients per hour that is the problem. To keep the hours from going crazy they might try to cram 15 patients into an hour. This is especially significant and is a direct result of medicaid reimbursements.
Click to expand...

For the record, I have never heard of a PCP seeing 15 patients an hour. That's ridiculous. 6 per hour is considered "too much" by most PCPs, and most practices will try to limit it to a max of 4 per hour.

Furthermore, the time crunch is not limited to PCPs. When I rotated through cardiology during pacemaker clinic, we were whipping through 6-8 patients an hour. A few of the cardiologists in that office were double booking patients (i.e. booking two patients for the same time slot) in the event that one patient didn't show. The ophthalmologist that I worked with says that he is routinely 45 minutes behind because they schedule patients for every 10 minutes, which isn't feasible.

Money is getting tight across the country, at all hospitals. We're all feeling the pinch, specialists and PCPs alike.
 
Dude, I feel your pain. My last dealer is in prison, and I now I have no idea where to get my angel dust.

... oh.... primary care physicians.... yeah...
 
OP: Do what you enjoy. That way you're doing us all a favor. I'd rather have a happy PCP than one who is miserable and doing simply because he feels he has an ethical obligation to do it and gets no pleasure out of it.

Believe me, the day-to-day work will wear down any feigned 'duty' to a certain specialty.

Also, I'm pretty sure PAs & NPs will be cornering a lot of the direct-care market of PCP work in the near future. As an example, try walking into an ER and getting an EM doc to suture your cut hand - it will be a PA, intern, or some other lower-level provider 100% of the time. Sure, FP and PCP docs will have to 'oversee' PA and NP work, but that's more management. If that's what you want to do, then go for it.

Yeah, and the lifestyle and family/work balance of a PCP is pretty bad - worse than other specialties - I'm not sure where you got your info regarding their lifestyle, but they got it rough.
 
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NH14 said:
OP: Do what you enjoy. That way you're doing us all a favor. I'd rather have a happy PCP than one who is miserable and doing simply because he feels he has an ethical obligation to do it and gets no pleasure out of it.

Believe me, the day-to-day work will wear down any feigned 'duty' to a certain specialty.

Also, I'm pretty sure PAs & NPs will be cornering a lot of the direct-care market of PCP work in the near future. As an example, try walking into an ER and getting an EM doc to suture your cut hand - it will be a PA, intern, or some other lower-level provider 100% of the time. Sure, FP and PCP docs will have to 'oversee' PA and NP work, but that's more management. If that's what you want to do, then go for it.

Yeah, and the lifestyle and family/work balance of a PCP is pretty bad - worse than other specialties - I'm not sure where you got your info regarding their lifestyle, but they got it rough.
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Sure, the simple suturing goes to a med student, intern/resident, or NP/PA, but anything complex goes to the EM doc. In our ED, the nurses and techs regularly remove sutures. The PAs typically put them in. Any fast-track pt is generally seen by a PA (although, occasionally, a fast-track pt will be upgraded and sent to a medical room or trauma bay and seen by a physician).

That said, EM docs aren't technically primary care (although, unfortunately, the public does not seem to realize that...).
 
gmcguitar4 said:
Even if I am more interested in other specialties do you think its a legitimate to become a PCP to help the current problem in the United States over my own interests?
Click to expand...

And so, my fellow Americans: ask not what your country can do for you - ask what you can do for your country. My fellow citizens of the world: ask not what America will do for you, but what together we can do for the freedom of man.

Sorry, but that's what the quoted line immediately reminded me of. Do what you like, not what you think is needed. Although, they don't have to be mutually exclusive.
 
Yeah, I have no idea what I want to do yet..I always envisioned myself doing primary care though. I could not be for me but I just have to wait and experience it.

Another question aimed at med student/resident/fellows/attendings: Did you go into medical school thinking you knew what specialty you wanted but changed your decision after experiencing all of the different fields?
 
Hm. I think this is an interesting post because I used to feel the exact same way that you are feeling right now. I'd say that over time, things change-unless you've had the opportunity to work in a variety of contexts, and have done all your rotations, it's hard to know truely if going into a generalist track is what you want to do.

I'm in the middle of the app cycle too, but it's interesting the impressions peers, professors, attendings, etc leave with you. Not saying it's great, but it's truely all talk until you get there and you decide a spec.

I think for now, the best thing is to keep an open mind, emphasize the importance of PCPs in efforts to provide continuous, comprehensive, and cost-effective care. And if you have a unique reason why you want to be a PCP, go for it. But otherwise, it's a long road ahead.
 
gmcguitar4 said:
So everybody is aware there is and will continue to be a shortage of PCP physicians in the US. I can definitely see myself becoming a PCP just by my personality and value of a life/work balance. But, I also consider being one to assist in the current shortage. Even if I am more interested in other specialties do you think its a legitimate to become a PCP to help the current problem in the United States over my own interests? Would you consider being a PCP to do the same thing? I understand everyone has their own goals and interests but I am just curious how you all feel about this and if it would make an impact on your decision to enter a certain field.
Click to expand...

No I don't think I would make my decision based on the US need. I am a selfish person and they would need to give me huge incentive to choose that over something else.
 
I think the most frustrating part would be that for the next 5-10 years people in all disciplines of health care are going to be lobbying that they can do exactly what you do with a fraction of the training, while most of them do nothing but mimic bad PCPs whose only answer is "antibiotics."
 
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