In the health care and health insurance blog worlds, there’s plenty of talk about a PCP shortage. But I’m curious about whether the average American – not involved in the health care industry other than as a patient – knows about the PCP shortage or sees it as a problem. Like many of our fellow health industry writers, we’ve addressed the primary care shortage issue, writing about how to attract more docs to primary care, and about how primary care physicians help to keep health care spending and technology use in check. We know that PCPs don’t earn huge salaries. (I know, $130K is a pretty big salary, but keep in mind how long one must spend in school and in residency in order to get the title of doctor.)
In browsing through this week’s Grand Rounds (highly worth the read, it’s a compilation of the best of the health care blogosphere from 2008, hosted by Laurie at A Chronic Dose) I came across this article by Robin at Survive The Journey. Robin writes from the perspective of a patient, and addresses the PCPs who are well aware of the problems facing their industry (a shortage of docs, and highly inequitable reimbursement when compared with what specialists pull in). Robin notes that there are plenty of PCPs in the blog world, and they often write about the issues facing primary care. But she points out that most of the people reading those blogs are also in the health care industry. The information isn’t getting out to patients and the general public. Robin conducted an informal poll of 22 people regarding what is wrong with our health care system, and the most common answer she got was that health insurance is too expensive. This is similar to data obtained on a larger scale by Harris Interactive earlier this fall – health insurance carriers get blamed more than any other group for the state of our health care system. Nobody in her poll mentioned a PCP shortage or reimbursement levels.
Our son’s doctor is a family practice doc in Boulder, Colorado. Last month I called to schedule a well-baby check for him and they booked an appointment for the very next day. No emergency, no illness… just a well check, and they were able to see him the day after I called. This is an established doctor who has been in town for several years. If I didn’t work in the health insurance industry and read health care related articles on a daily basis, I would have no clue that there’s a PCP shortage in this country, since my own experience (n=1) tells me otherwise.
For the purpose of this article, I called our son’s doctor’s office to see if they are accepting new patients with Medicaid. The office manager told me that they take a “limited number” of Medicaid patients, and that it’s up to the doctor to say whether she’ll take a new Medicaid patient on any given day. My guess is that it’s fair to say that patients with Medicaid and those without health insurance are probably acutely more aware of the PCP shortage than their neighbors with private health insurance.
People whose employers pay the majority of their health insurance premiums are often unaware of just how expensive health insurance really is. People with health insurance are often unaware of how expensive health care really is. People who aren’t experiencing a PCP shortage in their own lives tend to be unaware of the overall PCP shortage. And I’d say that it’s safe to assume that most Americans think all doctors (primary care and specialists alike) are rolling in money, driving Mercedes, and vacationing in Tahiti a couple times a year. Robin’s post is a good reminder that in order to remedy the problems facing primary care, the message has to get out to a wider audience. For additional info, her article has some great links to outstanding blogs written by primary care docs – Dr. Rob, Dr. Chan, and PookieMD – who write often and well on the subject of primary care.