Room for Growth by Pat Conrad MD


Is there actually an imminent doctor shortage? The Association of American Medical Colleges sure thinks so, predicting that by 2020, the shortage will be more than 90,000 doctors, including a 45,000 – 52,000 shortfall in primary care physicians. The organization gives three major contributing factors, which make a lot of sense:

  • An aging population, with more deserving seniors than ever before being herded into the dependency of Medicare.
  • ObamaCare has brought somewhere over 13,000,000 into the ranks of the “insured” (without creating a single new doctor, nurse, or hospital bed).
  • More doctors than ever before are seeking to retire.

And if that isn’t enough editorializing for you, then I’ll add a fourth: primary care, as popularly constructed, over regulated, underpaid, and over-sued…put plainly…sucks. It’s not fun and increasingly fewer rational beings want to do it.

States with higher concentrations of doctors have lower uninsured rates: “When doctors treat insured patients they are paid more than when they treat uninsured patients, incentivizing them to move to highly insured states.” But that could change quickly. The AAMC’s chief policy officer Atul Glover told 24/7 Wall St “that although the new federal health law will expand Medicaid coverage, the program, along with Medicare, tends to pay physicians between 30% and 40% less than private insurance companies.” So there is no new cash coming to providers, even as demand outpaces supply. In a rational world this leads to price increases, but in government-controlled health care where prices are fixed, it’s hard to predict a big influx of highly intelligent people wanting to work for government cut-rate.

AAFP Pres. and apparent Kool-Aid snorter Dr Reid Blackwelder thinks “this problem will be the prompt the system needs to address these long-standing issues with our medical system. He admits, though, that he’s a “glass-half-full kind of guy.”

“He suggests existing technology could help. Not all patients actually need to see him personally; if there is a way to set up an online system so patients could access records, e-mail simple questions or request prescription refills, that would cut down on the amount of time they’d have to spend in his office. Blackwelder also thinks a team approach would be more productive in health care practices — something many hospitals are already trying to adopt.”

Blackwelder might enjoy the 2014 Merritt Hawkins survey that found, “almost 45% of physicians plan to cut back on seeing patients, to take on fewer patients, to retire, or to restrict new patients within the next 3 years…81% report working at capacity or overextended.” The extra work he is volunteering primary care docs for is sure to turn these numbers around.


Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  3 comments for “Room for Growth by Pat Conrad MD

  1. mamadoc
    November 9, 2014 at 8:15 pm

    Ah, the president of the AAFP. He was a ninny when he was president of our state association and does not appear to have changed any. I would submit, however, that the guy is on something stronger than Kool Aid. I think he’s on whatever they’re giving to the AMA

  2. Bridget Reidy MD
    November 7, 2014 at 12:02 am

    Mmm. So the president of the AAFP thinks that prescriptions refill requests are a simple matter better done by email. Does he practice? Doesn’t every practicing physician give patients enough refills to last until their condition needs re-evaluation? Only patients think that’s simple.
    As a locum, I can tell you there are doctors who get this and doctors who don’t. Because although most patients think it is a simple matter even after you’ve just used your whole brain for 20 minutes and they feel and know they are well cared for, some doctors’ patients are surprised that you ask any questions at all. And those are usually the doctors with no problem list so you have to wonder if they even know what the drug is for when they refill it. And now I gotta wonder if the president of the AAFP is one of those doctors?

  3. politovski
    November 3, 2014 at 9:56 pm

    given that i have another 30 years in my career, socialized medicine doesn’t sound so bad. or perhaps working in a third world country, getting paid in goats and rice….

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