Primary Care: The Bastard Child of the Health Care Industry

With the economy in a recession and health care as the main topic of conversation, one thing is for certain: you can believe in change, even if it won’t be a change you believe in. There are a variety of ideas on how to improve the cost of health care and while I admittedly have not ready all of them, I will make the assumption that none involve pay increases for doctors.

Recently released in the Modern Physician’s 16^th annual Physician Compensation Survey was that more than half of the specialties that were tracked had compensation increases less than the rate of inflation . Primary care doctors were at the very bottom of that list, which should come as no surprise. It’s no wonder that the AAMC is forecasting a shortage of 124,000 physicians by 2025. How does this affect a universal health care plan, you might ask? Well when you decrease the number of physicians but increase the number of patients you find yourself in a predicament much like Massachusetts in 2006. 26 percent of residents had difficulty finding care and 35 percent of doctors stopped accepting new patients.

The Annals of Family Medicine reported that nearly one half of a primary care physician’s is spent on activities outside the examination room, predominately focused on follow-up and documentation of care for patients not physically present. Health Affairs that doctor interactions with insurers costs $23.2 billion to $31 billion a year. That is an average of $68,274 per physician per year for interactions with insurance companies.

Who is going to fill the void in primary care? It seems that either we would need 124,000 Mother Teresa's or that we would need the health care industry to brush up on it’s parental skills and coddle the primary care field. I personally do not know the answer on how to cure America’s health care woes, but it does not take a genius to see the problem. We have a rising cost for health care, a growing number of uninsured Americans, an increase in reimbursement below that of the rate of inflation and a shortage of graduating doctors willing to gamble their +$300,000 school debt on an under-appreciated and under-valued specialty. Just a fun closing fact, the top seven CEO’s for health care insurance policies earned a total of $14.2 million in 2008-2009. One source reported that over the past five years, health care insurance companies have posted 1000 percent increases in profits. Not to point fingers or anything but that increased health care money has to be going somewhere and it's certainly not going to the primary care doctor's pocket.