Like so many of the questions about our healthcare, we can follow the money to get to the bottom of the reason many of us may have trouble finding a primary care doctor.
Primary care doctors include family practitioners, internists, pediatricians and OB-GYNs. The amount of primary care doctors is dwindling in United States -- there are approximately 14,000 too few primary care doctors for the number of people who need them. According to the American Medical Association, the gap will increase to 25,000-30,000 by 2025.
Fewer practitioners means more difficulty finding one to help you, or making an appointment with the one you already see. You can see that the smaller numbers of primary care doctors would have an impact on your ability to find one for your care.
There are two problems that contribute to the shortage: The low numbers of medical students who are choosing primary care as a specialty, and the increasing numbers of Baby Boomers who require more and more care as they age.
Why are so few medical students choosing to go into primary care? That's where we follow the money.
Ask most newly matriculated medical students why they would like to become doctors and they will reply with answers that represent a certain amount of idealism. "I want to help people" is a common answer...
...until the realities of time and money become more apparent to them.
The average medical student finishes her education almost $150,000 in debt. She can pay off her debt earning less than $200,000 per year as a family practitioner, or she can pay her debt earning a specialist's salary which will be twice that amount or more. Which would you choose?
Primary care physicians find their day doesn't last 8 hours, or even 10 hours, but often many more than that. They may be regularly on call, 24/7 and working on weekends, too. While specialists may also find themselves working extended hours, they won't do so as often. Put another way, if you had your choice of being a dermatologist who worked a 50-hour week for $400,000 a year, vs a family practitioner who put in 80-hour weeks for half that amount of money, which would you choose?
Even the primary's day looks different. Because insurance reimbursements work the way they do, a primary care doctor is paid much less per patient visit or procedure than a specialist is. Therefore, a PCP must fit that many more patients into his day. The lower reimbursements go, the less time the doctor can spend with each patient because he must see that many more patients just to keep the lights turned on.
Now add all that up: Fewer students choose to be primary care physicians, meaning the ones that do exist are already squeezed for income and time, meaning then even fewer students will choose to become PCPs. It's a vicious cycle.
How Can You Find a Primary Care Physician Who Can Help You?
It's not easy. Begin with your insurance company's list of doctors, then work through the steps to choose the best doctor for you.
And when you get there, tell your doctor you understand how difficult her day is. She'll appreciate the consideration, and she'll respect you even more for your understanding.
You may want to consider seeing a nurse practitioner instead. Nurse practitioners are trained in primary care and can offer their services as part of a larger group of doctors and nurse practitioners, or in stand alone practices.
More Questions About Healthcare that May Be Answered by "Follow the Money":
- Why is it so difficult to find a primary care physician?
- Why do we see TV commercials or magazine advertisements about drugs we can't purchase without a prescription?
- Why do we have to be cautious about the outcomes of medical studies?