Primary Care Doctors Ask: Is it Worth It?

Dr. Jason Marker's family practice in rural Indiana is already overwhelmed. The office cares for 2,600 patients, at a rate of 100 a week.

"I think it is fair to say I'm bursting at the seams," Marker said.

To attract more doctors to primary care - one of the lowest-paid areas of medicine - the health care bill that's passed Congress provides financial incentives. This is a boon for Marker, who earns $120,000 a year.

CBS News Medical correspondent Dr. Jon LaPook reports Medicare will pay physicians a 10 percent bonus if most of their time is spent caring for the elderly.

Doc Dot Com: Family Doctors

Medicaid payments, which reimburse for low-income patients, will be raised about 20 percent depending on the state. But only for 2013 and 2014 - when a surge in Medicaid patients is expected.

A lot of practices lose money every time a Medicaid patient walks through the door.

Marker's fee for a routine office visit is $80. Medicaid reimburses him about $33. With the new law, he would get $47. He could earn more for coordinating care among a team of doctors, including specialists.

"As a family doctor, I'm looking at a net gain," Marker said.

Even with higher reimbursement rates, critics say reform won't attract enough primary care doctors. It offers little to defray medical school costs. Eight years ago, Marker started his practice already deeply in debt, at $140,000. Now he owes about $125,000.

Critics also say this plan does nothing to change the way specialists are paid per procedure, which results in them earning as much as five times more than primary care doctors.

"I think you can't talk to a doctor who once a week doesn't say, 'this is the fifth time I've filled out this form today. Is this really worth it to do this?'," Dr. Marker said.

What keeps him going?

"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," he said.

Marker is happy for the extra income from health care reform. But for him, practicing medicine has never been about making money.

  • Jonathan LaPook

    Dr. Jonathan LaPook is the chief medical correspondent for the CBS Evening News. Follow him on Twitter at @DrLaPook