The Struggle to Recruit Family Doctors

Like all good primary care doctors, Joseph Mambu is part specialist. An Orthopedist one minute, a cardiologist the next, reports CBS News correspondent Wyatt Andrews.

But Dr. Mambu does not get paid like a specialist. On average specialists make twice as much as primary physicians. A starting cardiologist, with three to five years more training makes up to $350,000 a year. A starting family doctor makes $149,000, mostly because they aren't paid for the extra time spent counseling patients.

"The only way doctors get compensated is by doing something to the patient," Mambu said.

"To the patient meaning some procedure?" Andrews asked.

"Exactly," Mambu said. "Nobody values what primary cares do - that's why we're in the crisis situation we're in."

Dr. Mambu is part of national experiment called Medical Home, which increases the pay and power of family doctors. His practice gets a 10 per cent bonus, and has hired extra nurses who stay in close touch with patients, handling the details of care.

It frees him up to spend more time with each patient, better manage chronic diseases like diabetes, and avoid any extra trips to specialists.

"If we pay primary docs more how does that save the system money?"

"Well, unnecessary and unwanted care no longer occurs," Mambu said. "I can't tell you how many people get referred, wind up getting worked up and really didn't need it."

But as the system begins to pay primary care doctors more, the pressure is on to pay specialists less.

Medicare just proposed a pay cut of up 40 per cent for specialists, like radiologists and cardiologists, and pay increases of up to 8 percent for family doctors.

Specialists complain the cuts will reduce their service in rural areas, and still not raise enough money to recruit more family physicians.

Jack Lewis doesn't think the changes will result in more primary care doctors.

"The cuts to cardiologists are devastating to them," Lewis said. "It's not even close to helping primary care in the way they need to be helped."

Without more help for family doctors - health care reform could make the crisis worse. If you think it's hard to see your family doctor now - imagine what happens when 45 million uninsured American start to enter the system.
  • Wyatt Andrews

    Wyatt Andrews is a CBS News National Correspondent based in Washington D.C. He is responsible for tracking trends in politics, health care, energy, the environment and foreign affairs.

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