Posted on 04/02/2016 6:36:53 AM PDT by george76
Primary-care shortage is growing especially acute in rural areas and in parts of some cities.
The doctor is disappearing in America.
And by most projections, it’s only going to get worse — the U.S. could lose as many as 1 million doctors by 2025, according to a Association of American Medical Colleges report.
Primary-care physicians will account for as much as one-third of that shortage, meaning the doctor you likely interact with most often is also becoming much more difficult to see.
Tasked with checkups and referring more complicated health problems to specialists, these doctors have the most consistent contact with a patient. But 65 million people live in what’s “essentially a primary-care desert,” said Phil Miller of the physician search firm Merritt Hawkins.
Without those doctors, our medical system is “putting out forest fires — just treating the patients when they get really sick,” said Dr. Richard Olds, the chief executive officer of the Caribbean medical school St. George’s University, who is attempting to use his institution’s resources to help alleviate the shortage.
Dr. Ramanathan Raju, CEO of public hospital system NYC Health + Hospitals, goes even further, saying the U.S. lacks a basic primary-care system. “I think we really killed primary care in this country,” said Raju. “It needs to be addressed yesterday.”
(Excerpt) Read more at marketwatch.com ...
“Fee for service” is the correct solution, always has been.
TANSTAAFL is the underlying principle.
Health “insurance” is the only product in America for which a person paying a dollar wants ten in return. If I could play the blackjack tables at Vegas with these odds I’d quit my job and fly out today.
Several mistakes our medical ancestors made decades ago. One was going to a third-party payment system in the hopes of actually being paid. Second was allowing “midlevel” practitioners into the practice.
The third-party problem isn’t going away soon, as a matter of fact, enshrined as it is in Obamacare, federalized as it were, we Americans are going to have cradle to grave care whether we like it or not and when we get older, too old to be of use (in the “complete lives” considerations of President Obeyme’s former science Czar) we’ll be told to “just take a pill.” Like it or not.
But of the other problem? In the “Free State” of Maryland - among others - Nurse practitioners can practice medicine autonomously, supervised only by other nurses, if any. There are many universities which offer “2-year BSN programs,” coast to coast. Considering the usual way is to cram a 2 year program into the more traditional 4 years, if the goals are met, same-same, poof, another nurse is produced. Then with the right connections - and/or subsidies from the benevolent and all-knowing all-powerful “state” - said 2 year nurse can now be accepted into a one year family nurse practitioner program.
does this happen? Sure. And even more so as the bureaucracy/government-created “doctor-shortage” becomes more acute.
After all, a traditionally-trained physician going to four years of undergrad, four years of medical school, a year rotating internship and three to five years of postgraduate medical residency producing a new doctor in only twelve to fifteen years is way too much to expect someone of above average intelligence and professionalism to expect to have his/her every clinical decision second-guessed by an 8th grade-level public education victim in a windowless office working for an insurer and/or state/federal medical agency. Day after day after year after year.
True story time, from a time shortly after the glorious people’s revolution of the Soviet Union, circa 1919. “Workers” from the laundry rooms of large hospitals would be given lab coats and stethescopes and told to replace the bourgeoisie physicians on the upper floors while said physicians would be sent to the basement laundry rooms (gulags or summarily executed as enemies of the state), because, comrade, in perfect marxist communist state, all workers are equal. Indeed, for many decades, physicians in USSR earned as much as cab drivers; from each according to his abilities, to each, according to his needs.
Now that the progressives (ahem, communists) have all but taken over every aspect of our economy, the gravy days of earning potential of physicians is rapidly coming to a close as the competition - three year wonders - are replacing us in droves. Like the teachers unions cranking out “educators” like so many ice cubes from a frozen intellectual tableau, each generation of public education victim replacing the former as the entire cycle serves to dumb down the educator to become a mere box checker in an education factory, the nursing factories are willing to dumb down the profession of medicine in like fashion so long as the money keeps rolling in.
The “state”, realizing the cost-savings, willingly blurring the lines between doctors, nurses or physician assistants by promulgating the my of the “equivalent” and ubiquitous “provider” plays a dangerous shell game of healthcare with the public as there is rarely anything of value underneath the shells being presented by the prestidigitation of the “managers” in HMOs and government-funded programs.
Want to see your medical future under such systems?
The VA.
They will get care because they go to the ER when you should go to a primary care physician. It’s the rest of us who follow proper protocol and procedure that will wait for necessary care. I should have seen my doctor last fall, but knew my issue would be addressed in a needed physical-appointments were over four months out. Dumb of me not to go to urgent care, but wanted to see my regular doc as that’s what my endocrinologist said to do. I’m better now, but felt awful all through winter and perhaps caused permanent damage.
Evidently the solution is to bring in foreign doctors.
I predicted back during the ObamaCare debates, based on observation of the British system, that it would drive a huge shortage of trained MDs; that the shortage would be filled by importing 3rd world ‘doctors’ of dubious training; that the world leading quality of the US medical system would be dragged down to 3rd world standards. Anyone looking and thinking predicted the same. We’re well on our way.
I work for a major medical system and I can tell you its not just primary care doctors that there is a shortage of. We will be shutting down services temporarily due to a shortage of specialty physicians such as psychiatrists - something the liberals and GOPe’rs will be needing after this next election.....
MAKE AMERICA GREAT AGAIN
There is, of course, a large segment of the US population for which that won't work. Many are simply too dull to manage their own health effectively. Factor in laziness and lack of personal responsibility and you have about 47% (I made that % up) of the population that is incapable of managing their own health.
Given the current political nonsense in America, I don't know how to fix that issue.
I recently went to a walk-in clinic for a sinus infection. No doctors anymore, I saw an NP. She told me that I had an Immune Deficiency Disorder, likely RA or COPD, and that I needed to see my Internist. Well, she scared me enough that I made the appointment. Turns out I have no immune disorders. I know I am lucky, but I miss when we could get reasonable care at a walk-in. Oh, and Dr Zeke also believes we should no longer get medical care after age 75 as we have outlived our usefulness to society. Yup, those death panels are real.
On virtually every patient that I see in the office, my computer flashes a red sign telling me that they are overweight and that I need to intervene. I offer to provide patients with healthy meals of brocoli and arugula, but after they talk to me they always head to the McDonald’s. How very frustrating.
And then the government dings me for not being active enough in the welfare of my patients. My golly, that’s even more frustrating.
The red flags by the way are government mandated. I could not turn them off even if I wanted to. That’s even more frustrating.
Let’s face it. Being a CPIT (computer-patient interface technician) is just frustrating business these days.
They are already here. Lots of them in this area.
Several years ago my GP retired ( along with 5 of my other Drs.)and I had to go out and find a GP that would accept new Medicare patients. Good luck!
Either Dr. Gupta, Patel, etc. Not implying they can't be good Drs. but comfort, language eases your mind.
Fortunately my wife's Dr. agreed to accept me.
Lesson... If you are in your 50s, get the Dr you want and stick with him/her. Get grandfathered in to his practice.
Right about Zeke since he basically said his own physician father should have died at 75, including gossiping about details of his medical history. I haven’t seen him on the shows much since then , although that may be just from embarrassment(I doubt he has the integrity to be embarrassed) over Obamacare; maybe one of his uncles landed one on his snout at the next family gathering.
Take it from a guy in the ER, few people seem interested in living a healthy lifestyle.
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