The Guilt Approach


I saw this article and was quite surprised at the approach they were using. Guilt.  It seems the only residency program in the state of Alabama that trains primary care physicians to serve rural areas is in danger of shutting its doors.  The reason, as this article states, is because Congress may repeal the Affordable Care Act.  Well, that’s it dammit!  They need to immediately withdraw the lawsuit because no one wants to lose Cahaba Family Medicine in Centreville, Alabama!!

I am a family doctor.  I support programs that train more of us instead of giving the specialty away to midlevels.  And I really  believe these doctors have their hearts in the right place.  That being said, it just amazes me when we, as humans, look at anything and only see how if affects us.  I am as guilty as the next person.  I know that.  I try, though, to look at the big picture and that picture is bleak for family doctors.  The reason is that no matter how well they train these doctors to work in rural areas those future docs still will be stuck with bogus quality metrics, worthless EMRs, ridiculous hoops to go through with Medicare and Medicaid, and still be paid the LOWEST of all doctors.  This approach is broken.  Repealing the ACA may do nothing to fix these issues either and I get that but the way the plan is set up now, I would never recommend ANYONE go into family medicine unless they did direct primary care.

If we all walk away from the insurers and Medicare and Medicaid and from the ACA then we could do a better job for patients at half the cost and finally get paid a reasonable rate. Or we can walk off the cliff like lemmings and beg people to keep one rural training site open.



66770cookie-checkThe Guilt Approach