Currently viewing the category: "primary care physicians"

Don’t say I didn’t tell you, cos I remember talking about this ad infinitum over the last two years. But the medical care you knew and loved is going away. And many reading this are perfectly happy about this, but not baby-boomers retiring to rural areas. Yes, seems that primary care physicians are hard to find in many small towns, and it looks like it may worsen.

Baby-boomers, the 78 million Americans born between 1946 and 1964, could have difficulty finding doctors over the next twenty years. With Medicare cuts proposed targeted under the federal health care overhaul, the shortage is likely to get even worse, said Mark Pauly, professor of health care management at the University of Pennsylvania. Primary care physicians out in rural areas make less per procedure in the Medicare schedule than their city counterparts, and with a cut in the already small reimbursement inherent in the system, doctors are running to the city in droves. Well, no duuuuuuhhhh…….

A 2009 survey of doctors in the Oregon Medical Association showed 19.1 percent of Oregon doctors had closed their practices to Medicare, and 28.1 percent had restricted the numbers of Medicare patients.

The good news is that we knew it was coming, right? Well, there’s at least one solution–Nurse Practitioners (NP). NPs can do medical exams, prescribe some drugs, give shots, take vitals, and so forth…sort of a doctor/nurse hybrid. It’s smart, and I like it. I have worked with a few NPs, and what they  can do—their scope—along with their competency, is top-notch. It’s like an all-in-one healthcare practitioner. I have lots of respect for NPs.

Now for you boomers who have decided to retire to rural communities, you may find that you’ll need to pay some things out of pocket. Just come to terms with that: health care is changing, and there’s no need to protest by neglecting your body. I know we all want to get what has been promised to us, and you know what…we just may, in fact, get that…but if for any reason it doesn’t go back to the way it once was, you still need your health. So take care of it, both by participating in health-enhancing behaviors (like seeing a chiropractor–also a primary care doctor, but sans prescription rights), but also by seeing your NP…hey many of them make house calls.

Listen, our old institutions are changing–in some ways for the better (like you taking a proactive approach to your health), and in others for the worse (quality will ultimately suffer, in my opinion). We’ve got to have creative solutions to these new problems–the easiest is to continue taking care of your body. But creating a self-funded medical account will probably be a wise move too.

Looks like medical doctors don’t care for this federal health care stuff. According to a recent survey, many primary care physicians plan to quit or drastically cut down their hours seeing patients because they are feeling “overworked.” 7,200 physicians surveyed said they would NOT recommend medicine as a career. Wow! Neither would I.

The doctors surveyed stated that they’re simply bogged down by paperwork; and this paper-pushing leads them to give less time to patients. For any doctor who is in the game to help people, I can attest, this is a frustrating situation. And it isn’t going to get any better with a universal health system, that’s for sure.

The paperwork attached to the federal health programs like Medicare, Medicaid, and other federal and state insurance plans is oppressive. Yes, yes, yes, there is some fraud going on, and the government doesn’t like being cheated. But the strain caused by the paper-pushing rigmarole is just too much. Geez. The feds think it curbs costs, but in fact, it reduces quality of care. And worse yet, our skilled and hard-working primary care physicians are ready to walk away. The only worthwhile career in medicine today is in specialization–surgeons, oncologists, anesthesiologists, and the like. Who wants to see 100 people in a day, and then stay in the office all night doing paperwork? Sure makes research sound good.

I have to sympathize with the doctors here. I understand why all this paperwork craziness is happening. Medical costs are spiraling out of control, and part of the problem is fraudulent billing–from doctors and hospitals. Understandably, insurance companies don’t want to pay for anything that hasn’t actually taken place–you know, double paying for surgeries, paying for patients who weren’t really in the hospital, and so on. But to overburden doctors with safeguards, in the form of government forms, and so much that patients end up losing quality of medical care just doesn’t make sense. Insurance companies just have too much damn power, and it’s time they stop being placed on the top of the priority list. Let them police their own damn suspicions, and if they catch a fraudulent doctor or hospital–then great, throw the book at them. But to have the support of the federal government in this documentation madness is just that–mad!

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