Posted on 01/30/2006 12:56:31 PM PST by libertarianPA
WASHINGTON (Reuters) - Primary care -- the basic medical care that people get when they visit their doctors for routine physicals and minor problems -- could fall apart in the United States without immediate reforms, the American College of Physicians said on Monday.
"Primary care is on the verge of collapse," said the organization, a professional group which certifies internists, in a statement. "Very few young physicians are going into primary care and those already in practice are under such stress that they are looking for an exit strategy."
Dropping incomes coupled with difficulties in juggling patients, soaring bills and policies from insurers that encourage rushed office visits all mean that more primary care doctors are retiring than are graduating from medical school, the ACP said in its report.
The group has proposed a solution -- calling on federal policymakers to approve new ways of paying doctors that would put primary care doctors in charge of organizing a patient's care and giving patients more responsibility for monitoring their own health and scheduling regular visits.
U.S. doctors have long complained that reimbursement policies of both Medicare and private insurers reward a "just-in-time" approach, instead of preventive care that would save money and keep patients healthier.
"Medicare will pay tens of thousands of dollars ... for a limb amputation on a diabetic patient, but virtually nothing to the primary care physician for keeping the patient's diabetes under control," said Bob Doherty, senior vice president for the
ACP.
The ACP plan called for innovations such as using e-mail to consult on minor and routine matters, freeing up expensive office visit time for when it is needed. Doctors would be compensated for an e-mail consultation.
The proposals include incentives for doctors to work more efficiently and to provide better care, ACP President Dr. C. Anderson Hedberg told a news conference. "ACP proposals would provide patients with access to care that is coordinated by their own personal physician," Hedberg said.
YOUNG DOCTORS AVOIDING PRIMARY CARE
The ACP cited an American Medical Association survey that found 35 percent of all physicians nationwide are over the age of 55 and will soon retire.
In 2003, only 27 percent of third year internal medicine residents actually planned to practice internal medicine, the group said, with others planning to go into more lucrative specialty jobs.
"Primary care physicians -- the bedrock of medical care for today and the future -- are at the bottom of the list of all medical specialties in median income compensation," the ACP said.
The group, which represents 119,000 doctors and medical students in general internal medicine and subspecialties, joins others that warn the U.S. health care system is untenable.
"If these reforms do not take place, within a few years there will not be enough primary care physicians to take care of an aging population with increasing incidences of chronic diseases," said Dr. Vineet Arora, chair of the College's Council of Associates.
Dr. Sara Walker, a Missouri physician, said she believed doctors were leaving general practice because of drops in Medicare reimbursement to doctors.
"A drop in Medicare payments will not only force me to stop taking Medicare patients but could force me out of business," agreed Dr. Kevin Lutz, a solo practitioner in Denver.
Too late. It has already failed.
Why would these stupid doctors want more government interference in their work? What could they possibly gain other than increased ways to defraud the patient and the feds?
Doctors say, "Just don't get sick!"
It's only a matter of time before the government starts to determine which doctors can go into special practice and which must go into primary care.
Right now, what's the incentive to go into primary care when your fees are pre-determined by medicare and the government regulates insurers to the point where they must deny any claim for procedures or therapies that aren't guaranteed solutions?
Bingo!
Because it's worked so well in the past. /sarcasm
The harsh truth is that the government has already confiscated huge amounts of money from the people who are already at, or near an age to be eligible for Medicare. That large chunk of the population has been forced into a position where they have little choice but to support the continuation of the government-paid health care system, since the government already has their money. Doctors know this all too well.
Well, yeah, what do they expect? Human med doctors make more than veterinarians, yet they both had to go to medical school. Is that fair?
HillaryCare is here.
bump
I think the biggest thing these docs are asking for is a restructure in the reimbursement plans of most of the HMOs. They will reimburse the regular family doc who is smart enough to diagnose a huge range of problems next to nothing- while a specialist who has one small field to dwell on a huge chunk of money. In my opinion, both are very important to our medical practices.
People need to quit going to the Dr. for every little ache/malady...and make them pay cash.....
"The harsh truth is that the government has already confiscated huge amounts of money from the people who are already at, or near an age to be eligible for Medicare. That large chunk of the population has been forced into a position where they have little choice but to support the continuation of the government-paid health care system, since the government already has their money. Doctors know this all too well."
That bears repeating! And as another poster said, people need to quit going to the doctor for every time they sniffle.
"Well, yeah, what do they expect? Human med doctors make more than veterinarians, yet they both had to go to medical school. Is that fair?"
AGGGH
LET THE FREE MARKET WORK
SHORTAGE OF PRIMARY CARE DOCTORS = PRIMARY CARE DOCTORS EARN MORE MONEY = MORE PRIMARY CARE DOCTORS = PRICE STABILIZES DEPENDING ON THE ELASTICITY OF PRICE.
A freshman microeconomics student could solve this.
Isn't this request what HMOs were set up to do ????? In an HMO you must go to a primary care physician first; so where's the real gripe ?
Medicare. Medicare. Medicare. Forcing doctors to see patients for lower rates than they want to charge.
Get the government out of healthcare, go to high deductible type insurance, rein in the trial lawyers, and see the vast majority of problems disappear.
This is already happening. The federal government, through its grants supporting research and teaching hospitals, has a great deal to say about how many specialists are trained. I am told that since Hillary decided that specialists are too expensive, the government has tried to curtail the supply in some fields.
I know a young medical-school graduate who wanted to be a surgeon. (He had a real talent for surgery.) But he was told that there were not enough surgery slots. He ended up in psychiatry.
That's exactly what Hillary's healthcare was all about.
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