HealthLawProf Blog

Editor: Katharine Van Tassel
Akron Univ. School of Law

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Wednesday, January 7, 2009

Shortage of Primary Care Physicians

As a part of their continuing series on the challenges of health care in the United States, the NewHour had an excellent story involving the shortage of primary care physicians in Massachusetts.  It is worth a read or a viewing.  Here is a brief excerpt:

JIM LEHRER: Next, the second of our stories on health care problems facing President-elect Obama and the next Congress. Tonight, health correspondent Betty Ann Bowser reports from Massachusetts on the shortage of primary care doctors. Our Health Unit is a partnership with the Robert Wood Johnson Foundation.

DOCTOR: Would you recommend interventional radiology as the way to go?

BETTY ANN BOWSER, NewsHour Correspondent: It's the annual career day for third-year medical students at Boston University.

DOCTOR: There are lots of procedures that are done, though, in radiology that are done in interventional radiology.

BETTY ANN BOWSER: They are engaged in a kind of academic speed date, moving from table to table every few minutes to hear doctors describe their specialties.

DR. THOMAS HINES, Boston University Medical Center: The most essential skill for a good family doctor is knowing what you know, knowing what you don't know, and being able to distinguish the difference between those two things.

BETTY ANN BOWSER: The students listen respectfully to the primary care physician, but the truth is very few of them will ever go into the field.

A recent survey published in the Journal of the American Medical Association found that only 2 percent of medical students plan to go into primary care. And since 1997, the number of medical school graduates going into the field has dropped 50 percent.

One reason is salaries. Family medicine doctors frequently are on the bottom of the pay scale, making an average of $185,000 a year. Specialists, like radiologists and cardiologists with two to seven more years of training, make two times that much.

Also, because of the sophisticated interventions and procedures specialists offer, they are paid more by insurance companies than primary care physicians.

Dr. Bruce Auerbach is president of the Massachusetts Medical Society.

DR. BRUCE AUERBACH, President, Massachusetts Medical Society: A primary care physician spending 30 minutes with a patient, talking to them about their health care needs, would get paid about a third of what a gastroenterologist would get paid for spending 30 minutes to do an endoscopic procedure.

And the young people certainly know that. And they're hearing that in their training. And they're seeing what happens. They understand the reimbursement system, very specifically values, those that are intervening with procedures rather than those that are sitting in an office and talking to someone about healthier lifestyle, weight reduction, exercise, taking care of their diabetes, and getting the right testing, and the like.

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