Will Insurance Alone Cure What Ails Us?

Baystate Medical Center is the second busiest emergency room in Massachusetts. They treat over 100,000 patients a year, but here's the thing: according to Dr. Niels Rathlev, who runs the ER, a quarter of them don't need his services.

"Well I think the way I would phrase it is to say I think that there are alternate sites of care that would be more appropriate," Rathlev said.

He means a doctor's office - a primary care doctor's office, reports CBS News contributing medical correspondent Dr. Sanjay Gupta.

"The majority of patients who are frequent utilizers of the emergency department actually have insurance," Rathlev said. "They have a primary care physician, but they choose to come to the ER because they don't have access."

Like Kenneth Mills, who is in pain from a bowling injury.

"I went and called my doctor this morning," Mills said. "But I wouldn't be able to get in to see him."

Mills is bruised, not broken, and could have easily been treated outside the ER.

"Are you kind of surprised that you had to come to the emergency room to take care of something like this?" Gupta asked.

"Well, I wish I had a primary I could just call and come in and I wouldn't have to wait as long," Mills said.

That's the issue: just having insurance doesn't guarantee access. There aren't enough doctors.

It's a real problem. In fact, according to the Department of Health and Human Services, we're more than 16,000 primary care doctors short in The United States.

About 26,000 new doctors enter the workforce each year, but only 6,500 enter primary care. One reason is that starting salaries for primary care doctors are a lot lower than for specialists - like in radiology, cardiology and urology.

"I've been in practice for 10 years and I still owe $60,000 in student loans," said Dr. Kate Atkinson from Amherst, Mass.

But it's not just the pay, it's the paperwork. Atkinson is drowning in it and says that's what's keeping doctors away from primary practices.

The reality here is that Atkinson and her nurse practitioner treat 3,000 patients, but filling out hundreds of different forms takes a staff of 11- so she simply can't make ends meet.

"Do you know that I lost a staff person to Starbucks last year because they could pay her more money than I could pay her?" Atkinson asked.

So how do you increase the number of family physicians?

Gupta thinks money plays a role. There has also been discussions of medical school loan forgiveness programs, which might help. But it's also the paperwork - it makes it hard for primary care physicians to get work done.
  • Sanjay Gupta

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