Skip to comments.Fewer doctors, more waiting
Posted on 12/02/2008 9:32:16 PM PST by george76
Lack of primary care physicians boosting health costs, hassles.
There were days last fall when Gabrielle McGrew felt she must be the most popular physician in Oregon and she hadnt even begun practicing.
McGrew is one of only three graduating residents who are choosing to practice primary care medicine, and the only one in Portland. Most of the other 31 internal medicine residents are taking fellowships that likely will lead to careers as specialists.
the long-term implications of the growing shortage of primary care doctors could be a disaster, experts say, given the steadily growing number of senior citizens ...
Those waits already are long for many Portland patients, especially those with Medicare or Medicaid health insurance. Those providers dont reimburse physicians at as high a rate as most private insurers.
About 45 percent of all Oregon physicians wont even take new Medicare patients... With a glut of patients and a lack of internists, McMullan says, they have begun rejecting the patients whose insurance wont reimburse them as well.
And its getting worse. McMullan says that a few weeks ago a BlueCross member in Salem, fully insured, could not find a primary care physician willing to see her. BlueCross staff said theyd help, but found the task insurmountable.
(Excerpt) Read more at portlandtribune.com ...
What are the communist / liberals going to do if they ever get their population controlling, socialized healthcare system?
Force people to become doctors? Lower standards to become a doctor? Salary caps on doctor pay?
The physician shortage in the United States is real and getting worse
I can play a Doctorb. :)
The B is for bargain!
the advancing age of the baby-boomer generation is creating a disease burden that will cause the demand for pulmonary and critical care services to outstrip the supply of specialists in those fields.
As people age, they tend to have more chronic diseases and are more likely to end up in the intensive care unit , Dr. Kelley reported ...
To formulate their predictions, the committee used national population, hospital, patient, and clinician data derived from multiple sources. Details of the study methodology are given in the box found below.
They've already done the second, talked about the third and will undoubtedly figure out a way to do the first.
They will also do what Britain has done - bring in oodles of third world doctors. Be sure to enjoy your next visit with Dr. Mohammed, who would love to see you dead.
If people think a litigious culture drives students away from medicine, wait until they see what government determined pay scales will do.
Oregon has a very socialized system already, doesn’t it? That would explain a lot. The more government is involved, the more there will be shortages, rationing, and a deterioration in quality and efficiency... not to mention higher and higher costs.
and "assisted suicide"
If physicians are government employees, they will have the right to strike especially when card check becomes law. Perhaps physicians should start a work stoppage for Congressional health care. That is one strike that I will support.
We are in for a hard lesson in economics with the rat plans for health care. Price controls will have devasting impacts on health care availability and quality. I just hope that the rats can experience the impacts. I have a feeling that the rats will find a way to insulate themselves from these nasty impacts.
Areas of the United States where the most care is delivered by primary care physicians have lower overall costs, higher patient satisfaction, and, as a rule, better outcomes.
A primary care doctor can be a trusted, friendly advisor who sees a patient over many years. When serious health problems strike, the primary care doctor can become the patients medical shepherd, helping to guide him through a complicated system of specialists and hospitals.
In any rational health care system, primary care doctors are central to keeping quality of care high and costs low.
I'm hesitant to favor the government forcing companies to stop having these stupid policies. Generally, nothing good happens when government starts forcing things. On the other hand, some companies really need to be knocked down a few levels.
You got it.
And if they think there are shortages of primary care docs now, just wait till the government forces them to work and not get paid.
How many will choose to spend 7 years in med school and $100,000 + in education costs/ student loans only to work in “free” clinics for pay far less than an Auto worker gets with basically no education requirements?
All of the above....
I have several Dr. friends who are ready to throw in the towel and retire early. They have been driven into group practices (due to liability ins. costs) and made to kowtow to guidelines, quotas, etc... so that it's impossible to give quality care to their patients. Their standard of living expectations are way below what they were 30 years ago... so the incentive to spend the time and $$ to go to med school has waned.
Rather than forcing people to become doctors, for the moment they are importing them as fast as they can. I've met new doctors at our local hospital in the past couple of years that could barely speak English, I couldn't even begin to pronounce their names, and I don't think they could pronounce mine. I wouldn't be a bit surprised if I learned they were throwing spears at animals just months before working at our hospital.
The insanely lengthy and expensive process of educating, not just physicians, but all healthcare professionals must stop as well. The goal seems to be to keep these kids in school as long as possible, bleeding them bone dry financially the entire time.
Costs and expenses are put under a microsope in every other area of society and business, yet NOTHING is ever said about the neverending, upwardly spiraling costs of education.
The greed and exploitation of BigEducation, to ...ahem... coin a phrase, from another, unjustly maligned industry.
See, those clever pols in Oregon have already devised a plan to overcome the shortage of doctors. Kill the patients.
You can blame the need for a docs note for employees missing too much paid leave on the unions who demand paid sick leave in the first place.
Companies attempt to reduce sick time abuse, which costs companies enormous amounts of money, by requiring proof of illness.
It’s not their fault that you can’t get in to see your doc. Perhaps the doc thinks you should really be at work as well.
If you really need to prove you were sick,
Go to a walk in clinic or ER instead. it’s not great sitting there for hours either, but what the heck, you’ve got the time, since you took the day off anyways.
besides, there was a time when all you had to do was call your boss and tell him you were sick, or your boss would see that you were sick, and send you home.
Thank the union for destroying that relationship as well.
Do you really think Obama is going to do anything that will stop the gravy train for the bloodsucking trial lawyer filth who were his biggest donors? No, there will be salary caps for doctors, PLUS unrestricted malpractice lawsuits. I wouldn't be at all surprised to see Obama push for a nationwide repeal of state laws that cap non-economic damages.
I don’t know why this hasn’t been a bigger story. Doctors have been leaving the practice for ten or more years now. Medicare is killing them off. It’s as much a crisis as it could be now.
With my own health plan... I’ve now been without a PPO doctor for a couple of years now. My doctor just up and quit. I’ve only lately (like today) finally found a new doctor. Have no idea how long it’ll last.
It's already the case that for many medical specialties, you'd be money ahead at the end of your career if you skipped college and medical school and instead became a UPS truck driver. With Obama, we can expect that this will be the case even for neurosurgeons.
We simply need to increase medical school admissions back to numbers they were 10-20 years ago. The federal government has forced medical schools and residency programs to cut back admissions.
There are many qualified Americans willing to go to med school. However, we must also warn them that they may have to go into primary care where they are needed.
The problem is that the payers, primarily government, pay much more for specialists, and so the med students naturally want to follow the money.
From the article:
“”Annual Physician Compensation
Family practice: $173,812
Internal medicine: $190,547
General surgery: $316,909
Emergency medicine: $256,800
Source: Medical Group Management Association “”
Oh yes, lets cut down on the length of time it takes to educate a doctor.
Why, anyone who can skin out a deer should be able to operate on a human with a couple of practice patients....
Brilliant idea that is, lowering education requirements. Why not have those flight by night ‘collages’ you see advertised on match book covers teach and certify doctors? heck, maybe they could take a mechanics course at the same time so their car never breaks down on the way to an emergency...
Also budget constraints prevents the latest (expensive) drugs and techniques to be used.
You are going to want to make sure that tort reform is well in place before we open streamlined “Doctor Nic” collages all over, right?
If you are a Doctor, right now, not in a socialized future, you have to hire AT LEAST one full time person at a minimum of $50k per year to deal with the insurance paperwork. That tends to take a good chunk off the bottom line. It’s just not worth it, unless you run a huge assembly line Medical Practice.
Brilliant idea to accept the status quo as correct and also to grossly exaggerate the concept.
There are GROSS inefficiencies in medical education.
Skin a deer? Infantile.
This sentence has to rank as one of the stupidest suggestions that I've ever heard on FR. The issue is not whether I "have the time." The issue is that if I'm feeling well enough to sit up in a chair and be somewhat civilized, I could be at work. I take sick leave because I don't have the strength to be sitting in a chair for very long.
I'm quite aware that the unions have caused more problems than they've solved, but union stupidity is often matched by management stupidity. Unfortunately, one reason that middle American voters don't trust conservatives is that too many conservatives refuse to admit management stupidity. We need to have the integrity to confront stupidity on both sides.
Oh please I am a Family Physician who is full at the office every day and I do not make close to that average. The tables and studies I have looked at put FP’s about about an average of 130,000 and I am below that thanks to MEDICARE AND MEDICAID poor payment.
Yes, that is a serious problem, and medicare, forced services for graduating docs (which will happen as a condition of accepting Obama’s free collage money) Will only make it worse.
The biggest problem a GP faces when opening a practice is insurance costs.
Simple torte reform, which Democrats absolutely reject, would go a long ways towards lowering those insurance costs.
The Doc opening a private practice has to insure not only himself, but his receptionist, his nurse, etc. Plus pay for hospital privileges at the local hospital, which is usually psid for with service duty in the ER; It’s all a huge expense for someone just getting out of medical school already in debt a hundred grand or more.
It’s not a stupid suggestion t all if you want a doctors note. if you can’t get in to see your regular doc, just where else are you going to get one?
So what if you have to sit and wait with a bunch of illegals and their crying babies who have a fever.
Here’s another “crazy’ suggestion. Take the day off without pay. then you won’t need a note from your Mommy...er doctor.
“Oh please I am a Family Physician who is full at the office every day and I do not make close to that average.”
You deserve much more Doctor. Believe me. I know.
“You are going to want to make sure that tort reform is well in place...”
An essential aspect of our society that MUST change, regardless of any changes that might occur in educational training.
And I have no problem with that. It's the WITH PAY part that I question. What makes you think you deserve pay when you aren't at work, working? The entire 'sick note' problem vanishes when that "right" you think you have for pay for services not delivered disappears.
My, that was a concise post!
Oh, and for your info, as an employer, the majority of “sick notes” I see from employees come from walk in clinic or ER docs because employees can’t get in to see their regular docs for notes.
They also charge more for those notes. :o)
Re third world doctors......they aready have brought them in. My mother ended up in the hospital last year and most of the doctors were from other countries - India and who knows where else - some looked Arab.
Sounds like you should move to Oregon ;)
Thanks, Doc. :-)
Better get used to it. We just don’t graduate enough docs to meet our needs. Far, far from it.
I just which they would teach them to say “Hello everybody” when they walk through the waiting rooms.
It it will continue to get worse when the people considering becoming doctors figure out they will be working harder for less money than people before them.
NCLB attendance rules have forced schools into insisting on doctor visits to excuse absences as well. I'd guess we'll be hearing more about pediatrician shortages next. They have to be in the same boat as primary care.
I’ve always thought, if I were a Doctor, I’d be a cash only doctor. No insurance accepted, and keep my rates lower.