Our healthcare system is in need of reform. Healthcare costs are growing much faster than the economy, and employers, government programs and individuals are suffering from this fiscal stress. We are unprepared to meet the future healthcare needs of our aging population. We have huge numbers of uninsured, and we rank behind other industrialized countries in common measures of health system quality. The economic downturn only exacerbates the problem.
It is important to realize that patients and employers are not the only ones dissatisfied with the current system—there are very high levels of physician dissatisfaction as well. Primary care physicians (usually considered to include general internists, family medicine and pediatricians) are particularly dissatisfied.
A survey by Lipner RS et al published in the 2006 edition of The Annals of Internal Medicine showed that 21 percent of primary care internists who graduated in the early 1990s have already stopped practicing primary care. In comparison, just five percent of internists who specialized have left their practices. This illustrates the high level of primary care physician dissatisfaction. Given this dissatisfaction, it is not surprising that a study by Hauer KE, et al in the September 2008 edition of JAMA showed that only two percent of all graduating medical students plan to go into practice as primary care internists.
Fewer physicians choosing and remaining in primary care coupled with the rising demand for services created by our aging population are projected to create a shortfall of 35,000 to 44,000 primary care physicians by 2025. Adding nurse practitioners and physicians’ assistants to healthcare teams will help to fill this gap, but a substantial gap will remain.
Why should healthcare reformers worry about the satisfaction of primary care physicians? Evidence suggests that countries with strong primary care systems have reduced hospitalizations, better preventive care and better coordination of care for patients with chronic diseases. This means that patients live longer, have better quality of life and spend less on healthcare.
As regional dean of UICOMP, I know our students and residents are committed to taking exceptional care of patients. I see their enthusiasm, dedication and compassion. They have devoted years of their lives and accrued huge debt in order to have the opportunity to practice medicine. As we work to reform the healthcare system, we need to assure that it satisfies the needs of primary care physicians as well as those of patients, employers and government programs. Working together, we can create a healthier America. iBi
Read the white paper, How is a Shortage Of Primary Care Physicians Affecting The Quality And Cost Of Medical Care? online at acponline.org/advocacy/where_we_stand/policy/primary_shortage.pdf.
