Growing Opportunities For Primary Care Doctors

By CityTownInfo Staff
April 15, 2009

The Chicago Sun-Times reports that one out of every five Americans does not have a family doctor, according to a Scripps Howard News Service review.  Within the United States there are 148 counties, mostly rural, where there is not a single doctor.  Benefits of having primary care are clear: Counties with more primary care physicians had lower death rates overall and lower death rates from preventable diseases. The federal count of primary care doctors is about 325,000, but this leaves thousands of communities without sufficient coverage. One third of Medicare patients have trouble finding a doctor, and two thirds of Americans have difficulty getting medical care at night or on the weekends. The situation is unlikely to improve, as few new doctors are training to enter primary care practice. 

The Naples Daily News reports on an Annals of Family Medicine study finding that "half of all specialist visits were for routine and preventive care that didn't require specialists, who typically charge more than double a primary care doctor." For at least a couple of decades, Naples county is unlikely to meet the government benchmark of one generalist per 3,500 people.  More medical schools are opening, enrollment is expected to increase 30 percent by 2015. 

The Arizona Daily Star covers the primary care shortage in Arizona. The state ranks 39th in the country for its primary care doctor to population ratio, making up only sixteen percent of the doctors in, for example, Pima County. High costs are lowering the number of solo primary care practices. Higher levels of primary care result in better outcomes for patients and lower health-care costs, according to Dr. Damsen Bassford of the University of Arizona's College of Medicine. 

Why more doctors are not in primary care is not difficult to understand. "Many find the routine of seeing patients all day every day a tough sell. People expect a lot out of physicians," said Dr. Merilyn Goldshmid, associate program director for internal-medicine residency at University Physicians Hospital in an interview with the Daily Star. "There is pressure to see many people in short periods of time. There are signs in some doctors' offices saying that they will discuss only one or two issues and if patients want to talk about more, they need to make another appointment."

Some health care systems are adjusting to the shortage of doctors. Local providers are offering  debt-forgiveness programs to help primary care doctors repay student loans, but doctors who stay in the practice are still rare.

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