Good primary care physicians are becoming harder and harder to find.
You may not have noticed it yet, but I predict that a year from now we’ll find it almost impossible to find primary care doctors who are willing to take on new patients – at least any primary care doctor worth seeing won’t be doing so.
Smart patients AND their advocates know that today is THE day to be sure they have good relationships established with primary care doctors.
Why? Two major reasons:
First comes the fact that medical students spend some time in school, then choose their specialty area. They contrast the excitement of surgery or saving a heart patient’s life, with the sniffly noses and broken legs of primary care. Then they figure out that as a surgeon or neurosurgeon,
it will take them only a handful of years to repay their student loans. As primary care doctors, who make far less than their specialist counterparts, it will take more like 15 or 20 years to repay those loans.
So what would you choose to do? So few medical students are choosing primary care these days, and so many are retiring, or leaving their practices, that the numbers of primary care doctors in the United States are horribly low. Estimates tell us we have between 15,000 and 20,000 TOO FEW primary care doctors in America.
The second reason is not an inside influence, but one that comes from the outside — WE are the reason. As the numbers of available primary care doctors dwindle, the numbers of people who need their help are climbing.
Baby boomers are aging – and the older we get, the more appointments, tests, procedures and follow up appointments we seem to need. The more we need, the fewer there are for others.
But the biggest hit primary care will take will not be from baby boomers. It will be from the 30+ million Americans who have not had insurance, but will have access to doctors once healthcare reform kicks in – between now and 2014.
All those new patients – and fewer primary care doctors. You do the math.
Smart patients know they need to establish a good relationship with a primary care doctor right away, if they don’t already have one. Make an appointment to get a check-up or to check out some dumb, nagging symptom you’ve tried to ignore. Then be sure you find a reason to get in to see that primary once or twice a year, otherwise you may end up being dropped from his or her roster of patients.
Smart advocates know that their client-patients need to have that relationship established, and will make sure their clients get that relationship established if it doesn’t already exist.
In fact, that may be what distinguishes you – and makes you the hero advocate – making sure that relationship gets established. Because once it’s impossible to do, you, the advocate, will get credit for making it happen when it was most important.
> Learn more about why it’s difficult to get a primary care appointment.
> Learn more about choosing a new doctor.
> > > > > > LEARN MORE > > > > > >
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Other professionals are stepping in to assist primary care. Nurse Practitioners (NP) and Physician Assistants (PA) are trained to be able to work side by side physicians. Many primary care physicians are seeing only the high risk patients and hiring a NP or PA to assist them in their practice to see the ‘well patient’. If there is something abnormal or new, the NP/PA will confer with the primary care physician and work together to develop the plan of care. Take time to learn if your primary care physician has a NP or a PA in his/her practice and get to know their role and how they can help you to keep well.
Excellent point, Anne, which raises two other points, particularly for any patients who find this post:
1. NPs and PAs are great for primary care. In some states, NPs sometimes work right in the doctor’s office, but in some states, they can have their own offices, in their own locations, but must be working under the auspices of a licensed physician. PAs are always found working in the same venue as the doctor he or she works for.
That means that we might make appointments with our physicians, only to be redirected when we get to the office, so that the person we really see is the NP or PA. All my experiences with PAs and NPs have been very positive, so I’ve never been upset when that has happened. But if the person who makes your appointment doesn’t tell you that you won’t actually see the doctor you think you will see, it can be disconcerting. The best approach, when you are making an appointment, is to ask who you will see, or to specify who you want to see.
2. Again – for patients – if you don’t know what a PA or NP is (they are also called physician-extenders) — you can check that out here.
I agree that there will be a great influx into the primary care system that may possibly overwhelm primary care physicians. Here in Knoxville, there are two schools that have started Physician Assistant programs, just to try and meet the need in our area.
I see this as a potential roadblock for patients, because PA’s and FNP’s, while continuously consulting with the Primary Care Physician, may not be as equipped in the “people skill” side of the healthcare business, resulting in increased customer service issues for the practice – and diminished care for the patient. Also, the patient load for these providers may be prohibitive to good communication.
While I am confident in the abilities of providers, I see these new changes as great opportunities for patient advocates to provide dramatic improvements in communication, cooperation, and overall patient care.
Michael Beach
President,
Healthcare Consumers Group, LLC
Knoxville, TN