Primary care physicians (PCP) are in high demand. Patient needs are rising and the PCP shortage is worsening. These multifaceted MDs are the “go-to” person for preventive and maintenance healthcare. They are critical players in the overall health care system.

Primary care physicians fall under the auspice of many titles: family doctor, general practitioner, pediatrician, internist, and family physician just to name a few.

The Statistics

According to the Harvard Medical School Center for Primary Care, only 2% of medical students are interested in primary care medicine. Since 1997, the number of medical students choosing primary care medicine has dropped by 51.8%. By 2020, the American Academy of Family Physicians (AAFP) predicts there will be 40,000 primary care doctors to serve the 78 million baby boomers in the U.S. The population of baby boomers, born form 1946 to 1964, constitutes a large portion of the patients who benefit from preventive and attentive healthcare as they begin to age and their health needs rise.

Primary Care Responsibilities

A PCP sees patients for preventive care, counseling and acute medical issues that arise. Traditionally, a primary care physician has a long-standing patient base, many of whom he/she has cared for over the span of many years. They have spent many hours together dealing with healthcare issues but also discussing personal concerns and developing a relationship. That was then, this is now…

PCPs are over-scheduled and rushed for time, everyday. Appointments are hard to schedule. Wait times have dramatically increased to as long as 3 months for a routine appointment. They see more patients in less time than in years past. There is no longer extra time to chat during an appointment. There is only time to address the issues listed on that wrinkled piece of notepaper most patients carry to their appointment listing their questions and concerns.

Seeing patients in their primary practice is not the only duty of a PCP. They also spend time answering correspondence, seeing inpatients, completing managed care referrals, and much more.

Why the Shortage of PCPs?

Unfortunately, it all comes down to money, in most cases. Medicare and private insurers reimburse physicians based upon the number of procedures they perform so specialists are well compensated. Family physicians argue that they are not reimbursed for talking to a patient about smoking cessation or weight management, both of which are as important as a tangible medical or surgical procedure.

Many medical students graduate from medical school with substantial debt, some in the vicinity of $200,000. A primary care physician’s salary averages $120,000 to $190,000 a year while a specialist earns more than double that salary. This is a conservative estimate according to many estimates. You do the math. Choosing a specialty becomes very attractive.

The Solution Isn’t Easy

There are many ideas circulating among the general populace and the Congress about how best to solve this growing healthcare crisis. Here are a few of the ideas:

• Pay primary care doctors more money. While this sounds like the simplest and most practical solution, no one wants to increase already outrageous healthcare costs.
• Add more nurse practitioners and physician assistants to medical practices to deliver routine care to patients. They would involve the PCP in a case, if a complex issue developed. A variation of this model is currently practiced at large healthcare facilities like Mayo, Cleveland and Lahey Clinics. This model is called an “integrated group practice” and is overseen by a physician or team captain. A recurring problem continues with staffing this practice: many nurses, nurse practitioners and physicians assistants have also chosen to work in a medical specialty, not in general medicine.
• A creative trend, called the Maine Track, is offered at Tufts University School of Medicine. Medical students who agree to fulfill their undergraduate training by staffing medical facilities in rural Maine are awarded a $25,000 a year scholarship. The downside: they are not obliged to become primary care physicians upon graduation. More programs like this are being evaluated.
• The government is evaluating the expansion of a program called the National Health Service Corps. This program helps to pay back student loans and offers scholarships and stipends if a medical student commits to working in a rural location for several years after graduation.

There is no easy fix for the current and expanding primary care shortage. Medical schools, government and the passion of a certain population of potential medical students need to work in unison to find the best way to provide the best care for the general public in a cost-effective way.

Do you have your next appointment with your PCP scheduled? If not, you had better get working on it. There will be a wait…