I went to medical school for all the right reasons – prestige, money and to meet a cute surgeon. What I found when I entered my residency was a profession on the brink of a financial and nervous breakdown. Not only did none of my colleagues even remotely resemble George Clooney, everyone was miserable. As an easy smile and a love of laughter are two of the qualities I find most attractive in the opposite sex, the dream of Dr. and Dr. went down the toilet. The compensation for 36 hour shifts with no sleep, call on the weekends and a baseline constant worry about my patients, was pitiful. Additionally, since the advent of medical advice on the internet (who reads this stuff?), lots of people began to feel that 10 minutes on-line was equal to years of education – and there went the respect. Still, practicing medicine was a dream come true. Don’t tell anyone because naively, the truth is, I always wanted to be a doctor because I wanted to help people. Little by little though, it seemed the helping, while not a small thing, was getting smothered by much bigger things — the billing, the charting and the arguing with insurance companies. Through high school and college summers, I sat a desk doing paperwork. I always knew I wanted to avoid paperwork as a career. Throw the realization that I would be spending most of my time pushing pencils in with four or five kids and you’ll understand my current state of unemployment. Sadly, my experience is not unique. Doctors in America are an unhappy bunch and are searching for a solution. These solutions might make for some very unhappy, possibly unhealthy patients. Here are the facts that define the problem.
1. There is a shortage of primary care physicians and it is only going to get worse. I LOVE being a family doctor. I love seeing a child with an ear infection, a hypertensive patient and doing a women’s health exam all within the span of an hour. Still, if I were in medical school right now, and needed to think about the financial health of my family, I’d forgo the job satisfaction, go into dermatology and shoot as much botox as possible. Primary care physicians receive the lowest compensation and, I would argue, need to spend the most time with their patients.
2. 10,000 baby boomers turn 65 each day – that’s a lot of needed health care. It is estimated by 2015, the shortage of physicians will number about 15,000. This number may be as high as 40,000 by 2021. Less conservative estimates put the primary care physician shortage at over 100,000 by 2025. The problem extends to specialists with a projected shortage of over 60,000 in the next ten years.
3. For patients, fewer physicians means longer wait times, a narrower choice when it comes to choosing a doctor and most disturbing, a decline in quality of care as doctors become more over-burdened.
4. #3 does not bode well for patients. Patient dissatisfaction with hospital and office visits is already on the rise. As medicine is becoming more and more a business operation, unhappy patients will have to be tended to like unhappy clients. Hence, the trend toward fee-for-service and boutique medicine – as in, you want better service, you have to pay more.
5. The proposed health care reform aims at health insurance for everyone – an ideal I firmly agree with. That being said, who is going to take care of all the newly insured. Having health insurance doesn’t guarantee access to care and it certainly doesn’t guarantee access to good care.
Doctors are dropping insurance plans at alarming rates. Many doctors are moving toward accepting no insurance at all. There are three sides to every story. Tomorrow, more on the doctor’s side of things. Friday, the patient’s side of things. I am finding it hard to take one side over the other and the Pollyanna in me just wishes we could all be on the same side. Let me know your opinion. Did your doctor drop your insurance? Are you having a hard time finding a doctor you like, or finding a doctor at all? Feel free to complain! As you can tell, I have no problem holding back in that department.