Katie Couric's Notebook: Primary Care

By: Katie Couric
Topics: Katie Couric's Notebook

You know the frustration. It takes weeks or months to get a doctor's appointment. And then you sometimes spend an hour or more in the waiting room. Well, bring a good book next time because that wait could get even longer.

A report from the American Academy of Family Physicians predicts a shortage of 40-thousand primary care doctors by 2020. Specialists tend to have more prestige and fatter pay checks. So, the number of students going into family medicine is only half of what it was a decade ago - and it comes as baby boomers begin to crowd offices looking for elder care. If Congress extends health insurance to more Americans, that would strain the system even further.

Lawmakers are considering several remedies; including expanded roles for nurse practitioners and helping family doctors pay off medical school debt. More GPs are needed STAT, so whatever prescription the doctor orders, it needs to be taken now before the health of the system is beyond repair.

That's a page from my notebook.

I'm Katie Couric, CBS News.

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by medicalconcerns November 11, 2009 8:11 AM EST: I couldn't agree more with the PA statements above. I and my entire family have been cared for by PA for years and could not be happier. There was one time when there was a nursing issue and the PA asked an RN and NP their opinion on it just as a doctor would do. Most people don't realize how similar PA and MD training is and even the fact that they actually re-certify to ensure they are up to date with their current MEDICAL knowledge. I guess this is one of the main differences is medical vs nurse training. If I have a medical problem, I will be seeing somebody with medical training and one that must prove they are safe to practice by taking boards not just once but on an ongoing basis such and PA/MD. I also agree if NP's were to be trained more they would be more like PA's. I read a great article showing that a PA even partially through their training with a BS already has almost twice as much clinical training than a NP does even considering experience as a LPN,RN,NP and even PHD, as well as having more college credits too. The College of Physicians posted a great position paper on NP's and their "clinical" PhD. They even pointed out that 7 of the 8 core areas of training are not clinical but rather things such as "the coaching model, promoting the profession" etc Sounds like PA's should stand up for themselves and need to be better represented.; Reply to this comment


by EJ0519 September 24, 2009 7:33 AM EDT: Kudos to KMJ above... great comment! My primary care doctor has a PA (Physician Assistant) and I see the PA all the time. He is absolutely amazing... extremely smart, always knows his limitations, and has not steered me wrong in the 7 years I've been going to this office. In fact, I often see the doctor asking him to come look at one of HIS cases to help him with the diagnosis. That is a real partnership. Meanwhile, I've been to weekend walk-in pharmacy store clinics before and seen Nurse Practitioners. Let me tell you, I'm not impressed! Sure, they seem to care and offer a smile and a handshake, but I feel like I'm seeing a nurse, not a doctor. When I see my PA, I feel like I'm seeing my doctor!

Katie Couric and her research team need to get out there and realize that PAs have been doing this for a long time and the Physician/PA Team model works. Stop trying to replace doctors with nurses and start advocating the use of the resources you already have people!!!; Reply to this comment


by tallt14 September 23, 2009 10:12 AM EDT: Free market economies, like all things in nature, abhor vacuums. When the lack of primary care physicians outweigh the glut of specialists, the value of primary care docs will increase. Thus, more med school grads will get into primary care.

At least that's what will happen if the federal government doesh't start messing around with the system. Unfortunately, there appears to be a fat chance that will happen.

I can see a physician czar telling med schools how many primary care grads to produce over the next decades. The future looks very, very scary.

Tallt14; Reply to this comment


by petersemkiw September 22, 2009 11:30 PM EDT: It's always good to have a pocket edition of the collected works of William Shakespeare handy. {;-); Reply to this comment


by kmj1874 September 22, 2009 10:11 PM EDT: I usually enjoy this 5 minute snapshot of Katie's notebook page, but today had me a little concerned. I am currently a physician assistant working in a Family Practice office in Southeast Michigan, an area hard hit by our economic times. I recognize, as do many of my peers, the need for more family practitioners (MD, DO, PA or NP). We have a serious problem on our horizon.

My issue with your "note page" is with this comment "Lawmakers are considering several remedies; including expanded roles for nurse practitioners and helping family doctors pay off medical school debt."
Expanding the roles of nurse practitioners?? I don't mean to toot my own horn, but wouldn't expanding that role make them physician assistants? It has been shown that PAs do and continue to fill the gap for the lack of MD/DO in primary care. A physician assistants' education does mimic the medical school model, with the attention to increasing patient education. We are focused on primary care, with the option of specializing in another field. I'd offer that you google "physician assistant" or go to the american academy of physician assistants website (aapa.org) to find out more on my profession. I feel that we are excellent "mid level providers" because of what we offer to the patients. MD/DO as well as lawmakers need to continue to tap into this resource since we are already doing this job, especially in primary care.

Understand, I am not knocking our NP peers--they are needed. However, I think that lawmakers need to look at expanding the roles for all "mid-level providers", not just NPs. Physician Assistants ALREADY bring a level of expertise in primary care that is addressing the MD/DO shortage.

Oh yeah, toot toot; Reply to this comment

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