America's Primary Care About to Collapse

I have been harping on this for a while.... Did anyone listen? No.
Guess what? It couldn't have timed out better...right at the time when
boomers are getting ready to retire. Another thing, don't expect money
to buy you out of this one; it's a little late to be thinking about
that. This is one (of many) fucked up situation that has festered for
years because nobody felt like doing anything about it. Not to
worry...the exceedingly brilliant, Yale alumni-Skull and Bones George
Dubya Bush will save the day...he will have our health care system
running like a well-oiled machine before you know it, right? In the
meantime, enjoy your future physicals....in Jamaica, Mexico, Denmark,
Canada, Germany, etc.... Or maybe you will actually get that
just-in-time e-mail reply from a first year med student advising you of
your quadruple bypass options.

This country sure does a fine, outstanding job in managing its
priorities, eh? ...BTW, anyone know what is on American Idol or ESPN
tonite???


Igor sez.......I told ya so!!!


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Primary care about to collapse, physicians warn
Group proposes solutions for changing reimbursement policies for
doctors


Updated: 3:14 p.m. ET Jan. 30, 2006
WASHINGTON - Primary care - the basic medical care that people get
when they visit their doctors for routine physicals and minor problems
- could fall apart in the United States without immediate reforms,
the American College of Physicians said Monday.

"Primary care is on the verge of collapse," said the organization, a
professional group which certifies internists, in a statement. "Very
few young physicians are going into primary care and those already in
practice are under such stress that they are looking for an exit
strategy."

Dropping incomes coupled with difficulties in juggling patients,
soaring bills and policies from insurers that encourage rushed office
visits all mean that more primary care doctors are retiring than are
graduating from medical school, the ACP said in its report.

The group has proposed a solution - calling on federal policymakers
to approve new ways of paying doctors that would put primary care
doctors in charge of organizing a patient's care and giving patients
more responsibility for monitoring their own health and scheduling
regular visits.

U.S. doctors have long complained that reimbursement policies of both
Medicare and private insurers reward a "just-in-time" approach, instead
of preventive care that would save money and keep patients healthier.

"Medicare will pay tens of thousands of dollars ... for a limb
amputation on a diabetic patient, but virtually nothing to the primary
care physician for keeping the patient's diabetes under control," said
Bob Doherty, senior vice president for the ACP.

The ACP plan called for innovations such as using e-mail to consult on
minor and routine matters, freeing up expensive office visit time for
when it is needed. Doctors would be compensated for an e-mail
consultation.

The proposals include incentives for doctors to work more efficiently
and to provide better care, ACP President Dr. C. Anderson Hedberg told
a news conference. "ACP proposals would provide patients with access to
care that is coordinated by their own personal physician," Hedberg
said.

Young doctors avoiding primary care
The ACP cited an American Medical Association survey that found 35
percent of all physicians nationwide are over the age of 55 and will
soon retire.

In 2003, only 27 percent of third year internal medicine residents
actually planned to practice internal medicine, the group said, with
others planning to go into more lucrative specialty jobs.

"Primary care physicians - the bedrock of medical care for today and
the future - are at the bottom of the list of all medical specialties
in median income compensation," the ACP said.

The group, which represents 119,000 doctors and medical students in
general internal medicine and subspecialties, joins others that warn
the U.S. health care system is untenable.

"If these reforms do not take place, within a few years there will not
be enough primary care physicians to take care of an aging population
with increasing incidences of chronic diseases," said Dr. Vineet Arora,
chair of the College's Council of Associates.

Dr. Sara Walker, a Missouri physician, said she believed doctors were
leaving general practice because of drops in Medicare reimbursement to
doctors.

"A drop in Medicare payments will not only force me to stop taking
Medicare patients but could force me out of business," agreed Dr. Kevin
Lutz, a solo practitioner in Denver.

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