These Doctors Always See You

The picture above is from the article The Doctor Won’t See You Now in the WSJ. It is NOT the example I want to show you. Here is a better example:

That’s Dr. Michael Ciampi at https://www.ciampifamilypractice.com. He has the normal amount of Direct Primary Care patients, which is in the 600 range and he is able to see ALL his patients without the help of people who are not physicians (just playing doctor).

The article I reference states: The traditional experience of getting health care is shifting away from the solo doctor with limited time to spend with each patient and few incentives to promote wellness. Instead, in the future, patients will be more likely to see a team of health-care professionals whose compensation is linked to keeping patients healthy. That team may be led by a doctor, but with a growing shortage of physicians, a nurse practitioner is increasingly likely to be in charge. Patients will also receive more care virtually and in nontraditional settings such as drugstore clinics.

It doesn’t have to be this way. This is a concerted effort to create this story. Administrators want it to save money. Drug stores want it to save money. Insurers want it to save money. NPs and PAs want it so they can say they are the same, or even better, than doctors. They are not.

The Association of American Medical Colleges projects a shortfall of as many as 55,200 physicians going into primary care by 2033. More medical students are opting for higher paying specialties. Meanwhile, the ranks of other health professionals trained in the field have been on a steady climb. The American Association of Nurse Practitioners estimates there are more than 290,000 licensed in the U.S., with close to 70% involved in delivering primary care. There are also about 131,000 physician assistants, with about 21% working in primary care.

No one wants to go into primary care because of everything this article says. It is a self-perpetuating cycle of death for this profession. And as this happens, the AAFP fiddles. The only hope for primary care is DPC (Direct Primary Care). It’s time that the AAFP continues to market and publicize the MASSIVE differences in education and training between doctors and NPPS (non doctor providers). It’s time the AAFP pushes the MAJORITY of its conferences towards DPC.

Or the speciality will die.

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A Collaborative Work From Some of the Writers at Authentic Medicine

These editorials are from some of the writers here at Authentic Medicine. The opinions expressed by these authors do not necessarily purport to reflect the opinions or views of other writers of this blog. Each collaborative work may, in fact, be from different authors.

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8 Responses

  1. Stewart says:

    “It’s time that the AAFP continues to market and publicize the MASSIVE differences in education and training between doctors and NPPS (non doctor providers”

    Continues? How about begins to?

    • Kurt says:

      They’re too stupid to do that. I retired from a group practice and the docs were stuck doing EHR after Obama rammed it down our throats and the administration didn’t want to “lose” the 3 to 5% payment (or whatever the heck it was) if we stuck with paper. The AAFP is slitting their own throats by their silence and deserve extinction.
      DPC won’t work everywhere. In an environment with a high percentage of public aid, one will go bankrupt. Therefore one needs to choose their geographic area wisely. As I see it, not many DPC docs do hospital care or take call anymore. It’s pretty impossible to do that anymore anyways.
      Oh, BTW. The AAFP still wanted $895.00 to renew my membership even though it was for a “retired lifetime”. Yeah like I’m going to travel to a stupid CME conference that I don’t need anymore. (I kept my money.) No retired MD is going to go back to practice especially if their malpractice insurance provider gives them a one time coverage for tail insurance if they’ve been with the same provider. If I went back, I’d be on the hook for ~$30,000.00 so I be permanently bye-bye till I’m planted in the ground.

      • Kimberly Chapman says:

        I’m DPC. I’m on call for my patients and would gladly round on them when they are admitted to the hospital, but the hospitals here all use hospitalists, and my orders are not accepted. So (pre-COVID)I just made a visit to the patient at the bedside, got their authorization to look at the chart and discuss their care with the treating physician, and explain to the patient what was going on. Now that I’m not allowed in the hospital at all (COVID), I can call, text, or FaceTime my patients in the hospital.

        • Kurt says:

          Kim, That’s a good thing but I had started out in 1988 in the classical office, hospital and call routine.
          It worked well until Obama destroyed it with mandated EHR. Yeah, I know one doesn’t have to do EHR but it will cost ya’ not to do it. I’m out of here at 64 and don’t miss it one iota’. Sad thing to have to say for a profession if you ask me.

  2. Rick says:

    I thought I had a grasp on things in general but this WSJ piece was a real eye-opener. Mama mia. “Just call me Wendy…” She doesn’t even specify that she is only a NURSE. My God.

  3. Fred Powell says:

    The writing is chiseled into the wall. Physicians learned nothing from watching anesthesiologists give their trade to CRNAs.
    I cannot see things get better from here forward. I dread being a patient in the system.

  4. Ken Luckay DO says:

    Excellent piece. So true. DPC practices are the future that will restore good patient care, and satisfaction to the doctors providing it.

    • Kurt says:

      Bear in mind, DPC will not work everywhere. In a geographic place that has too many impoverished folks, a DPC practice will fail miserably. That is the reason that most all of the private practices of old failed!

      Let the “gubbermint” get involved to pay the monthly fees and expect a new s#itload of rules to have to comply with. Will totally subvert the model of practice then.

      Pick ones geographic site for DPC carefully PLEASE!!

      Don’t want to end up a Doc who ends up bankrupt.

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