Sometimes I am amazed at the ignorance of the media. The NYT just put out an article entitled “Doctor shortage likely to worsen with health care law“. You think? I have and others have been saying that for years. The ACA (Affordable Healthcare Act) really kicks in in 2014. The Association of American Medical Colleges estimates that in 2015 the country will have 62,900 fewer doctors than needed and that number will more than double by 2025. And what we really need is primary care docs and there is little interest from students to go into this field. Sure, the gov’t can talk a big game about provisions in the ACA to pay us more but the bottom line is that specialists get paid twice as much as us. The law won’t do jack to fix that disparity.
I am seeing this issue right now in Virginia as hospitals and private groups are finding it difficult to hire family docs. Patients are coming to the urgent care where I work and just can’t find anyone to be their primary care physician. It make me sad. In Maine, where I left, my former employers were so cocky in their belief that I was easily replaceable. Well, they couldn’t even find a locum tenen to help and it has been four months. As for finding a permanent replacement, they have NO leads. But it doesn’t even phase these professional administrators. Heck, they don’t really do any work and don’t actually take care of patients so all they have to do is spin some bullshit. In fact, I am convinced that they believe that a doctor should lead a team of LELTs (Less Experienced/Educated, Less Trained) practitioners and that will fix all the issues. In fact, my former physician “leader” even came out and said that to one of my partners. Why? Because he is a quitter and a sellout. All these idiots know is to shuck and jive in order to survive. They have no new ideas of their own so they follow what the government or insurance companies tell them to do. This causes the need for more administrators to be hired to comply with these new rulings and the cycle continues.
So what are the answers? We are so screwed up now that it won’t be easy. Here is a section on this site where readers have been adding their ideas. Please send me yours. For now, I will reiterate some important recommendations. I would start with paying primary care doctors more. I would get some tort reform. I would cut the amount of administrators in the medical world by over 80%. I would destroy the present insurance model and go only to a catastrophic one and then let people pay cash for rest. This would lead to prices coming down and better direct pay models to PCPs. I would remove at least 30 to 40% off the Medicaid rolls just by culling the herd of those fraudulently abusing it. And, I would add a monthly “Medicaid” fee to every one of their cell phone bills since they all seems to have one (with data and texting). I know the last idea isn’t feasible but it sure was fun to say.