The Struggle to Recruit Family Doctors

(CBS)  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.

[peggyeren]

Once again, CBS news dropped the ball and gave a very incomplete view of primary care in this country. There are more than 100,000 nurse practitioners in this country, most of whom are educated in primary care. Further, NPs are ready, willing and able to provide high quality care. This does not mean we don't need physicians in primary care. We should remove barriers to NP practice to make sure Americans have access to high quality health care.

[peggyeren]

Once again, CBS news dropped the ball and gave a very incomplete view of primary care in this country. There are more than 100,000 nurse practitioners in this country, most of whom are educated in primary care. Further, NPs are ready, willing and able to provide high quality care. This does not mean we don't need physicians in primary care. We should remove barriers to NP practice to make sure Americans have access to high quality health care.

[erasmus111]

by rightaboutit July 29, 2009 8:50 AM EDT
You don't think they have bills like every body else? I just had one that lived behind me move to a more practical home.


Gee, that's tough, ain't it?

If he was getting paid what he should have been getting paid, instead of getting a ridiculous amount of money, he wouldn't have had to move. He would already be in a "practical" home.

You like them sucking you dry of your hard earned money?

You're being ripped off! You like them getting away with that?

[chinadoc]

i was a chinese doctor before i came to US. i wanted join family medicine training program but unfortunatly no any program responded to me yet. i am wondering if any program interested in me since we are short of family doc @ any where. I hope it's true, i saw the number on the news.

[lawyertom1]

General practitioners are underpaid in a major way. We need many more to help with the preventative aspect of health reform. We are also short of neurologists, another endangered species. Reform needs to address such shortages.

[cynthiah777]

We know the value of a Family Physician. I am glad to see the recognition in this article. Currently we are looking to recruit an FP for our practice. If interested, please visit :
http://www.siteskins.net/cflhealthcarecareers...
or contact me directly at [e-mail]

Cynthia Hernandez,
Practice Manager

[iam4honesty]

Wow, that's an interesting way to recruit a physician. Good luck competing with the hundreds of 'large' headhunting companies out there. My wife gets calls every day.

[xlib]

Oh sure, bright young people will just run to enter med school to be a family practitioner. Why, with a thug in charge who just bad mouthed doctor's yep, they sure will want to work for this thug.
Say, don't know if that was covered in your state run media. Perhaps I should fill you lemmings in. See, I believe it may have been on Monday but the thug was droning on and on with teleprompter at hand and he made the statement that you could take your child to the Pediatrician for frequent sore throats and the the Pediatrician would perform a tonsillectomy to "fill his pockets". Yea, that was another one of his bright, show the populace who I really am statement.
I really don't know the last time a Pediatrician performed tonsillectomies. I thought an ENT doc did that. Could be wrong.
But yea, saying things like that will really want someone to get into medicine.
I'm sure there may be some bright members of ACORN that would enter for him.\
I just posted that to get some of you lemmings PO'd.

[helloall34]

In the US, primary care is going to happen mostly at Walmart and CVS (like it or not), it has already started. Specialization will happen more and more via live web links (that too has already started). The knowledge that once allowed doctors to make lots of money is not as scarce as it once was, making it less valuable. Cheap health care is not only possible but very likely, the only barrier is the status quo. It is just a matter of time before these changes are common place. Will quality go down ? Maybe, but likely not. It's already generally not too good in the US. People will be able to be seen more often and therefore more preventative steps can be taken, this will improve health care.

[erasmus111]

"The cuts to cardiologists are devastating to them,"

I bet it will be. They have been getting paid zillions of dollars more than they are worth. It's about time they are brought down off their high horses.

[hamiltongrad]

why not pay them like lawyers, talk to them on the phone= 150, type a ltter =350, ask how they are =54 $.


THE REFORM WE NEED FIRST IS LEGAL . IT IS KILLING ALL OF US. THAT WOULD BRING DOWN THE COST OF MEDICINE PRONTO. DON'T HOLD YOUR BREATH.