Doctors Face Patient Influx

With the passage of health care reform, an estimated thirty two million new patients will try to find primary care doctors. That's not going to be so easy because we already face a shortage of primary care doctors and about 13,000 more will be needed to take care of those newly eligible for insurance.

According to the American Medical Association, there are about 312,000 primary care doctors practicing in the United States. That includes family medicine, general practice (GP), internal medicine, and pediatrics (in addition, there are 43,000 ob-gyn's, who also may serve as primary care doctors). The estimate that another 13,000 will be needed comes from a study done by the Robert Graham Center for Policy Studies in Family Medicine and Primary Care in partnership with the Agency for Healthcare Research and Quality.

Sixty five million Americans already live in areas that don't have enough primary care doctors. And relief is not on the way anytime soon. It takes 5 to 8 years for a first year medical student to be trained as a primary care doctor. And the trend for budding doctors over the past decade has been away from primary care and towards more lucrative specialties.

The new legislation contains some incentives for entering into primary care. Medicare will pay a ten percent bonus to doctors spending most of their time giving primary care to the elderly. Medicaid payments will be increased by about 20 percent in 2013 and 2014 to reach 100 percent of the Medicare rate. This is important because about 16 million new patients will be eligible for Medicaid and many doctors currently don't accept Medicaid because reimbursement is so low. In addition, primary care doctors will be paid extra for coordinating care among a team of doctors.

The new incentives are a good start but more is needed to increase our supply of primary care doctors. For this week's CBS Doc Dot Com, my producer, Heather Tesoriero, and I traveled to a rural community in Indiana and discussed the shortage with an old-fashioned family practitioner named Dr. Jason Marker. When he started practice eight years ago he was $140,000 in debt from medical school loans. He works long hours and sees about 100 patients a week but still owes $125,000. But Dr. Marker isn't in it for the money and he's not looking to heal only the well-healed. The day we visited him, a man walked five miles to his office from a homeless shelter. When I asked Dr. Marker what keeps him going after a rough day, he admitted that sometimes he wondered if it was all worth it. But then he added, "And then you go into the next room and you have a little old lady give you a big hug and you're ready to go again."

Please click here to watch my interview with Dr. Marker.

[MSDdotorg]

As a medical student I am well aware of the primary care shortage. So are my classmates. But very few of us have aspirations for primary care (only 5-9% will go primary care). When my classmates talk about their dreams, it is an unspoken rule that none of us want to go primary care, partly because of the onerous job and partly because of our desire to not be in heavy debt for the rest of our lives.

Schools need to stop raising prices by 5% a year. A doctor can and should be educated for less money. It'll be good for primary care.

- Frank, www.medicalstudentdebt.org

[babooph]

Up until the bribing lobby in the 70s Drs from schools over seas could take US state board exams & practice in the US-their education costing only a small%% of what it is in the states could lower costs even more....

[MattAnders]

The shortage of doctors will be an issue. We have nurse practitioners and physician assistants to help with the workload but that may not be enough. One solution that may work is the respiratory therapy Initiative. It would give grater power to respiratory therapist who hold the RRT credential and have a 4 year degree. Here is more information.

The bill that will help is HR 1077 in the house.
http://www.opencongress.org/bill/111-h1077/text

Or S 343 in the Senate.
http://www.opencongress.org/bill/111-s343/show

AARC has diligently pursued changes in Medicare that would bring patients greater access to respiratory therapists outside the hospital setting. Through support from AARC members, pulmonary patients and the respiratory therapy community at large, legislation is being considered in Congress that would meet this goal.

Congressman Mike Ross (D-AR), an influential member of the Health Subcommittee of the House Energy and Commerce Committee, introduced our Medicare Respiratory Therapy Initiative as HR 1077

On the Senate side Senator Blanche Lincoln (D-AR) and Senator Mike Crapo (R-ID), key leaders on Medicare issues in the Senate, have jointly introduced the same legislation -- S 343. This legislation will, when passed by Congress, amend portions of the Part B Medicare law to allow certain respiratory therapists to deliver a broader array of services.

With the introduction of both HR 1077 and S 343 we are well on our way to seeing a major step forward in the recognition of respiratory therapists under Medicare.

[Patriotson]

We are adding somewhere between 32 million to 42 million to the insurance program and there is evidence doctors are leaving the medicaid and medicare system.
I know personally three doctors who are saying enough is enough and will not be treating patients in this socialized european health law.
Businesses like john deere and catapillar are already voicing concern about the costs this law is going to have on them and that they may be reducing work forces. Small businesses are not prompted to expand their business because of the excessive mandates and costs assoicated with this law. Our economy is about to go into a tailspin.

[farmertommy]

THIS IS JUST ONE MORE TEA BAGGER/REPUBLI'CON'

SCARE TACTIC,

WHAT A BUNCH OF UN AMERICAN LIARS THEY HAVE BECOME

[MattAnders]

did you read the story? It's in favor of the health care bill. I hardly see something in favor of the bill being a movement of the Tea Party. Now stop using childish names and read before you submit.