Is there really a primary care physician shortage? How tough is it really to get a new doctor? I hear lots of opinions, but does anyone really know?
The current administration apparently backed off a plan to look into how difficult it really is to get an appointment at a primary care physician office recently. Personally I think it’s a shame that public pressure kept the U.S. government from doing what any reasonable business would do prior to trying to make a major financial decision. Would you as a businessperson want to know the extent of a problem prior to initiating a solution to the problem? Would you consider using a secret shopper to accomplish that task? For most people I suspect the answer is yes.
The plan was to have “secret shoppers” make calls to 4185 physician offices in 9 states to assess how difficult it is to get a new patient appointment. I’m not sure if the “patients” were going to have Medicare, Medicaid, or commercial insurance, or some mixture of these. I’m also don’t know how they picked the states involved, but if any of them are anything like the community I practice in the results would have showed that if you have government insurance, i.e. Medicare or Medicaid, it is very difficult to find a new physician.
The reasons are very simple. Most of the primary physicians are really busy and despite no shortage of patients are struggling to manage overhead costs and declining reimbursement. There is little incentive, and lots of reasons not to accept more patients where the payment for services is much lower than the payment for similar services for commercially insured patients. The survey proposed would have been inexpensive to administer, and would have brought into the light the scope of the problems we are going to face as the current plan to bring a large number of newly insured patients into the market in the next three years.
A brief article in the N.Y. Times gives a few more details about the issue, but I think the administration wimped out on this one. Sometimes you just need to do the right and smart thing even if it draws criticism from opponents.
Administration Halts Survey of Making Doctor VisitsBy ROBERT PEAR
Published: June 28, 2011
WASHINGTON — The Obama administration said Tuesday that it had shelved plans for a survey in which “mystery shoppers” posing as patients would call doctors’ offices to see how difficult it was to get appointments. Read more
At our office recruitment has been challenging for the last year or so, and I think that there is a major shortage of primary care physicians looming. Unless something changes the rate of retirement of primary care doctors will out pace the rate of new young replacements, and this situation will get worse.