Why are Primary Care Doctors Disappearing?

 Why is it so Hard to Find a Doctor?

The wealth gap between primary care doctors and procedure-driven specialists is increasingly forcing primary care physicians to become a vanishing breed.

Medical practitioners have moved away from becoming internists, and have started choosing specialties, because that is where the money is. We ask why it is becoming so difficult to find dependable internists or primary care doctors in your network.

Follow the Money

Specialists make more money, and they can profit from increased efficiency. Technological developments allow medical procedures to be streamlined and performed more quickly. Medical providers are rewarded for providing services by insurance reimbursements and patient fees. If they can provide services more quickly, they become more profitable.

Medical specialization allows practices to rely increasingly on paraprofessionals and technology to increase productivity and, therefore, income. We have seen increased roles for paraprofessionals in the medical workforce. At the same time, there has been a boom in technology, including wearable tracking devices, teleconferenced medical visits. These changes have enabled specialists to provide testing and evaluations that used to be time-consuming and risky with less risk and time. That translates into greater profit.

The primary care doctor, on the other hand, has been unable to streamline patient interaction to anywhere near the same degree, and now has a less profitable kind of practice. The need for computer record keeping has tended to redirect physicians’ attention from the patient to the keyboard. There is a limit to the amount of patient care time that can be cut from a schedule before it becomes ineffectual.

Care Has Become a Consumer Product

Along with the trend away from seeing a general practitioner to seeing a specialist, there has been a trend toward seeing health care as a consumer product. There is an increasing amount of advertising involved in health care. Billboards advertise not only hospitals but doctors and specialized facilities. Drugs and services become less-regulated consumer products.

You have only to look at urgent care center economics to see how profit plays out. Tests like blood tests, x-rays, CT scans, MRIs, and EKGs are amongst the most profitable reimbursed medical procedures. An urgent care setting can take the profit from tests and leave less profitable patient care to other facilities. Further, the need for such tests in a medical emergency is seldom questioned any more than a damage restoration service such as Servpro is questioned during an insured property loss.

What Can We Do?

Since the medical field is evolving rapidly, insurance fees for service are inevitably out of date and in constant need of revision. If we want to create a pool of general practitioners, we will need to equal out the wage gap between specialists and generalists and look more closely at the direction that profits from insurance payments push the healthcare market. If we feel patient care is necessary, we need to prioritize rewarding it.

Author: Linda DeSolla Price

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