The end of primary care

[soeagerun2or]

I always hated these threads about articles but this particular one struck a nerve. http://online.wsj.com/article/SB120710036831882059.html?mod=hpp_us_personal_journal

How do people feel about ancillary staff determining themselves that they are capable of providing primary care independent of a physician. What will happen to fields like Family, Internal, and Pediatric Medicine? Should a more firm definition of what medicine is and limitations on who can practice "medicine" be sought?

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[pseudoknot]

It's too late. It's over. I haven't seen an MD for primary care in years, personally. I doubt it matters, since doctors don't have time to do anything complex during 10-minute primary care visits anyway.

 

[NCF145]

How do people feel about ancillary staff determining themselves that they are capable of providing primary care independent of a physician. What will happen to fields like Family, Internal, and Pediatric Medicine? Should a more firm definition of what medicine is and limitations on who can practice "medicine" be sought?

The only specialty that I really think is in jeapordy of being lost to NPs and PAs is Family Medicine.

 

[pseudoknot]

The only specialty that I really think is in jeapordy of being lost to NPs and PAs is Family Medicine.

Yeah, that's what I was talking about.

 

[ColinHay]

I think thats fine.
let NPs and PAs do primary and physicians will only do specialty.

 

[McDoctor]

Since this thread is big on anecdotes so far, I'll mention that most of the mid-levels in my area are in specialty care. If you see the local GI practice, a CRNP will determine if you need a colonoscopy, EGD, or both, and then throw in sprue antibodies for good measure, even if you weigh in excess of 300 pounds and your chief complaint is constipation. The doctors exist to do endoscopies. The local cardiologists run the same type of practice, existing solely to perform catheterizations whether necessary or not and ordering B-natriuretic peptides on everyone who sneezes.

As far as Family Medicine "being lost to NP's and PA's", don't hold your breath. As long as healthcare remains a free market system (albeit just barely), I'm not overly concerned about being outperformed by a mid-level. Anyone who is should have saved their medical school tuition and went to nursing school.