Need for More Primary Care Physicians
In a recent opinion piece in Modern Healthcare, Richard Scheffler, professor of health economics and public policy at the University of California at Berkeley, and director of the Nicholas C. Petris Center on Health Care Markets and Consumer Welfare, declared that more primary care physicians are needed in order to address the physician shortage in the US. He states that the US needs comprehensive health policy reforms that will encourage an efficient, cost-effective and quality healthcare system, and this can be done by attracting physicians to practice primary care.
Professor Scheffler is of the opinion that the US physician shortage can be better addressed not by increasing enrollment in medical schools, but by attracting more physicians to primary care. Experts have shown that people living in areas with more primary care physicians have better overall health than those living in areas with less primary care physicians, even with accounting for age and income differences. These experts have also found that areas with more primary care physicians also have much lower healthcare costs.
According to Professor Scheffler it costs $1 million to train one physician. Physicians who have just graduated from medical school typically owe $150,000 to $200,000 in school loans. Because of this, these physicians routinely choose medical fields with a high earning potential, and these fields are not primary care positions.
In addition to higher salaries, specialty medical fields are more attractive to physicians since they have more regular schedules and there are fewer pager calls from patients on nights and weekends. Professor Scheffler also cites a national survey of medical students from September 2008, showing that only 2% of medical students were considering general internal medicine as a career.
In his article, Professor Scheffler affirms that physicians will be attracted to practicing primary care if the system rewards them for doing so. Inducements such as debt relief for those willing to practice primary care will help attract physicians, as well as reforming health care payments to using a single payment for a group of related services.
Patients’ payments should also be used to cover preventive care and health education, which will encourage greater use of health professionals such as physician assistants and nurse practitioners. This will mean better schedules and fewer pager calls for primary care physicians, thereby relieving some of the pressures off of these physicians.
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