Physician Shortage Growing, But Not From Health Care Reform

Last week, we posted a very interesting article frompreventative medicine that takes out the big middle
the New York Times regarding the physician shortage,man (insurance companies), he is frowned upon.
and how it's about to get much worse. You're probably 
thinking that this impending physician shortage is due toPerhaps one day we'll dive into the psychology behind
the passing of health care reform, but you'd bea patient's reactions to concierge medicine. It would be
surprise to know that much of it has nothing to do withan interesting study to understand why this form of
health care reform. Concierge medicine may be moremedicine insights such interesting responses. But I
of an option than you ever realized.digress.
  
As recently as 2005, more than two-thirds of medicalWhat's interesting about the decline in private practices
practices were physician-owned — a share that hadis that they just aren't equipped to handle the changes
been relatively constant for many years, the Medicalthat health care needs to be making. For example,
Group Management Association says. But within threetake electronic health records. They will be required
years, that share dropped below 50 percent, andnow that health care reform has passed, but private
analysts say the slide has continued. (NYTimes)practices just don't have the time, money nor
 resources to convert their practices electronically. 
Medical students are not only opting out of primaryThese computer systems are extremely expensive
care and turning to specialized practices, the very fewand incredibly time consuming to set-up. Imagine
that are choosing primary care are graduating with sotransferring every piece of paperwork in your entire
much student debt that they have no choice but tooffice to digital. It would take a lifetime. Small practices
accepted salaried positions at hospitals and healthcannot compete with large organizations that have
systems. There is no longer any incentive for studentspeople who do nothing else but transfer data.
to open, or even work in private practices. 
 For older doctors, the change away from private
Physician's wages are decreasing while their overheadpractice can be wrenching, and they are often puzzled
is going up. Their hours are getting longer while theirby younger doctors' embrace of salaried positions.
families are suffering. Patients are getting 
‘assembly line' treatment and diagnosis instead of"When I was young, you didn't blink an eye at being on
proactive, preventative health care because primarycall all the time, going to the hospital, being up all night,"
physicians are taking on more and more of them tosaid Dr. Gordon Hughes, chairman of the board of
cover costs. Where does it end?trustees for the Indiana State Medical Association. "But
 the young people coming out of training now don't
According to The New York Times article, patients arewant to do much call and don't want the risk of buying
losing the "intimacy of longstanding doctor-patientinto a practice, but they still want a good lifestyle and a
relationships" when so many doctors are choosingbig salary. You can't have it both ways."
salary over care. It's such juxtaposition, an ironic reality, 
where graduating students are turning to salariedConcierge physicians kind of do have it both ways.
positions where they can make more money andThis is what's interesting about this entire discussion,
spending less time with patients, and are respected forbecause by converting to a concierge practice, your
their choices. However, should a family physician whosalary improves, your patient-doctor relationship
has been practicing for years decide to convert to aimproves due to your 24-7 availability and on-call
concierge practice so he can become a morestatus, your quality of care improves, and overall things
effective doctor, spend more time providing affordableare pretty good.