Primary Care Shortage: What does this mean for you?

[vanbamm]

With the shortage of MD/DO primary care doctors, and the anticipated increase in that shortage, what are you being told/taught in school? Do you profs teach that you should be able to take on that challenge for patients who can't get access to a primary? Do they prepare you any different during the first 4 years? Just wondering- as a non MD/DO (DC), we are told to be ready for these types of patients and stress further education in the field to be better able to serve them. I disagree because of the lack of training in my field on this area, as well as other doctors that serve in another capacity- even so, do you think that you would attempt to help them if you had the ability to?

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[NatCh]

Most of the posters on this subforum are far out of school, so we're not being directly taught anything in school from Professors (or at least I'm not).

I'm not planning on taking over primary care duties.

I predict physician extenders (PAs, NPs) will become a big part of the primary care workforce.

 

[fivescrew]

vanbamm, are you taught anything of value towards filling a pcp's role in chiropractic school? Seems kind of irresponsible for a school to bring that up to their students when a DC doesn't practice any type of medicine. Do they mean they want you to be better prepared to refer out to the proper physician or do they really want you to study up on basic common illnesses etc. Don't get me wrong, DC's have a valuable role(I swear by mine) but is dispensing medical advice and care one of them?

I'm curious, this is an interesting topic.

 

[vanbamm]

All I can say is that while in school learning the basic fundamentals (I am currently in rotations now), we spent alot of time on clinical diagnosis and physical exams in order to recognize problems. I think this is okay in order to make connections, but it is out of the scope of the profession to be able to treat certain conditions that a PCP would.
I think at best, we can screen for things and refer. The issue I see (and am currently doing research on) is the issue of putting other healthcare providers in the position to deal with patients as a primary, when it is not part of their scope of practice. I would hope many know well enough not to believe they can be a primary, but for those that think they can, it isn't right or fair for the patient.
It needs to be helped, and this doesn't mean creating more physician extender roles.

 

[densmore22]

All I can say is that while in school learning the basic fundamentals (I am currently in rotations now), we spent alot of time on clinical diagnosis and physical exams in order to recognize problems. I think this is okay in order to make connections, but it is out of the scope of the profession to be able to treat certain conditions that a PCP would.
I think at best, we can screen for things and refer. The issue I see (and am currently doing research on) is the issue of putting other healthcare providers in the position to deal with patients as a primary, when it is not part of their scope of practice. I would hope many know well enough not to believe they can be a primary, but for those that think they can, it isn't right or fair for the patient.
It needs to be helped, and this doesn't mean creating more physician extender roles.

There's absolutely no problem in performing an H&P in order to ascertain more about a complaint a patient may have. It's even prudent to initiate a work-up (basic labs, rheumatological labs, CERTAIN imaging), but it would be very inappropriate and malpractice to TREAT said condition if it had nothing to do with the treatment you are providing that person for their foot care. Asking the right questions + ordering correct tests and appropriate diagnostic studies + referring back to the pt's PCP/a specialist = good medicine and making good connections with other medical professionals, IMO. Treating when it has nothing to do with the foot and ankle = setting yourself up for a whole bunch of hurt. You know what, it may seem like we're being "limited" or not "taken seriously," but honest to God, the Ortho's at a nearby major University (VERY prestigous) Ortho Residency lost their privileges to medically treat their patients. All pt's under the ortho service in that hospital system HAVE to have Medicine managing their patients. They got tired of them making too many mistakes. Trust me, the deeper I get into it, the less I want to manage all my patients issues (because most of them have MANY MANY ISSUES). The DC summaries alone will make you loathe being primary on some of your patients...

 

[vanbamm]

I agree- staying within your scope is the best way to go about things regardless of how you might feel about shipping the pt to another person- in the end you are going to get referrals for making the referrals-and be respected more for doing "your" job and letting other people do "their" job-i'm rotating now and if i feel like i'm still suspicious after the h&p and in office tests- i refer- some of the low income people come in and just want either us or others (pods, dentists, optometrists) to take care of them so they dont have to go to the MD/DO- but most of them are coming in at a point where it is no longer preventitive or need to see a specialist- i try to as much as possible take care of what i can so they dont have to go spend a ton of money, but really i can't do a ton- some people i'm around (DC's and others) try and do everything- i feel like it is more a disservice than a service.