TH - Pirmary Care Shortage

TH - Top News Article:
"The Georgia study suggests changes to insurance reimbursements hurt primary care by rewarding the delivery of diagnostic tests and medical treatments, instead of rewarding time spent communicating with patients.

'What has happened with the physician payment system historically is that it has given a higher value to procedures over cognitive care,' Hubbard said.

Family medicine physicians have the lowest average salary ($185,740) of the doctors studied, compared to radiologists and orthopedic surgeons, who had an average salary of more than $400,000.

'When a medical student chooses a specialty, potential income is becoming more and more of a factor in that decision,' Hubbard said.

Knox fears access to care could become restricted if a primary care shortage continues.

Physician assistants and nurse practitioners can fill some of the gaps left by a dearth of primary care physicians -- to a point.

'There is a higher level of qualification required to provide some of the services that physicians provide,' Tracy said.

Pechous said the economics of training and retaining new physicians is complex.

The debt load facing medical school graduates is one of the impediments to enlarging the pool of primary care doctors. For M.D.s, that debt is pushing $130,000, Tracy said.

'It is like a second mortgage.'"

Another interesting statistic:

"At the University of Iowa's Roy J. and Lucille A. Carver College of Medicine, 37 percent of the incoming class entered the family medicine field in 1996. By 2006, that number had dropped to 10 percent. In the early 1990s, Iowa graduated nearly 45 family doctors per year. By 2006, that dropped to 12."

Thanks to Dr. Pechous for writing this. The solution, really, is obvious. Pay more for the behavior you want and less for the behavior you don't want. Higher reimbursement for primary care services, lower for procedures. This is not "class warfare" for physicians, it is simply facing simple economics and the consequences of reimbursement rates.

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