All I hear is how once we have everyone covered by some form of health insurance there will be this big improvement in access to care. Have you tried to get an appointment with a primary care physician lately? It’s hard enough if you have a doctor and nearly impossible if you don’t. What this shows is that there is a drastic shortage of family physicians and internists. What happens from a numbers standpoint if 46 million people suddenly have coverage and feel that they can go to the doctor? Who is going to see these people? The system can’t support the number of patients that it is trying to see now. The only good thing that I can see coming out of this is that the emergency rooms and ER physicians who are absolutely swamped will finally be getting paid something for the patient care they are providing. When I worked in the ER back in the mid 1990′s our physicians group had a collection rate of 40%. How many businesses do you know that could operate on a 40% collection rate? I have heard nothing in Washington about how to increase the number of primary care physicians. They are trying to replace as many as possible with physician assistants and nurse practitioners.These providers can take care of many simple patient problems and don’t cost near as much in salary as a physician while they can generate almost as much income. But as most everyone realizes there is no replacement for a physician’s education. If there were, physicians training would last a couple of years like that of these mid level providers. It takes 4 years of medical school and at least 3 years of residency training (after 3 – 4 years of college) to produce a new family physician or internist. Add to that the disrespect that primary care gets in the training programs and from other providers, the salary disparity with other specialties, the burdensome reams of paper work, and the long hours.There is not much incentive to go into primary care. I have a friend whose daughter just graduated from pharmacy school (5 years TOTAL training) and she started at a higher salary than a family physician friend of  mine makes after 15 years in practice! Yeah, all doctors are getting rich! If you are uninsured and think healthcare reform will mean that you will have your own doctor, think again!  bjmdjd

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access to care · family physicians · internists · primary care physicians · universal care