Reform Proposal #3

In order to decrease health care costs and increase access to health care in America, the United States Government needs to create incentives for future medical students to enter the primary care sector. These incentives should include reimbursement of student loans for medical school, along with a bonus for signing on for at least ten years in the primary care sector. Throughout the past 40 years there has been an overwhelming decline between the ratios of primary care physicians to specialty care physicians. Specialty physicians have increased by a whopping 118%, while primary care physicians have only increased by 18%. Specialty physicians are qualified in a specific segment of medicine. Some examples might be pediatrics, surgery of all types, and anesthesiology. Specialty trained physicians commonly require additional years of advanced residency training along with several years of practice in the specialty, and being certified by taking and passing a specialty board exam. Primary care physicians, on the other hand, provide more preventative care and treat more common illnesses like head colds and non-life threatening injuries (cuts and bruises).

The fact that our system has too many specialty physicians and not enough primary care physicians affects the ideas of cost, quality, and access for citizens throughout the United States. The increase of specialty physicians is a result of the innovation of all kinds of new technology. However, the increase of specialty physicians is causing an increase in the usage of expensive tests and procedures to treat patients, even when they are unnecessary. This is causing part of the increasing health care costs. Quality of care is also negatively affected by the increase of specialty physicians, partly because of the income gap between specialty and primary care physicians. According to primary care physician Kevin Pho, “. . . The resulting income gap between specialists and primary care providers has serious consequences. Primary care providers may resort to shorter patient visits, with adverse affects on the satisfaction and well-being of their patients.” This fact is quite startling, but it shows how a primary care physician is not viewed as a prestigious and important study of medicine. This ultimately affects the quality because of attitudes of physicians, and even patients, have toward the area. Shortage of visits may also be a result of the lower ratio of primary physicians to patients. Along with quality and cost, access is also affected. With the baby-boomer generation becoming older, there will need to be an increase in primary care physicians to carry out simple vaccinations and yearly physicals. If the rate of primary care physicians stays the way it is now, there will be a significant shortage in few years to come as the baby-boomers age.

As stated in our stance on this issue, we firmly believe that all people should have equal access to health care since we view it as a basic right; we value life and care about the disadvantaged. We believe that the government should be actively involved in health services delivery to decrease overlap and excess spending since we value effectiveness and efficiency. Therefore, by implementing an incentive program to increase primary care physicians, we would decrease costs and increase quality and access. Increasing primary care physicians would decrease costs because the use of unnecessary tests and procedures would decrease. Also, an increase in primary care physicians would increase preventative services, thus, decreasing tertiary actions to treat disease and decrease costs. Quality of care would increase because the more preventative services provided decreases the amount of disease and mortality. An increase of primary physicians will increase a value in primary care. These physicians will feel as important as specialty physicians, thus will be more likely to ‘give it their all’ to patients. An increase of primary physicians will increase access to health care by creating more time slots for appointments and even more flexible times for appointments (i.e. weekends and later hours). This will be a significant factor in the next five to ten years because of the baby-boomer generation.

By giving incentives to future medical students enter the primary care field, will only generate benefits to patients and tax payers because of the decrease of costs, increase in quality care, and more access to care.

Now that Obama’s Health Care reform bill has been passed in Congress and signed, there will be an increase of the population entering the health system because the uninsured will now be covered. The idea of increasing primary physicians is key in creating an effective and efficient health care system for all!

Sources:

Physician Kevin Pho’s ideas on the shortage of primary care physicians:
Pho, Kevin. "Primary care-specialty income gap: It’s worse than we think." KevinMD.com. N.p., 23 May 2007. Web. 29 Mar 2010. http://www.kevinmd.com/blog/2007/05/primary-care-specialty-income-gap-its.html
The American Medical News portrays the struggles between specialty and primary care physicians:
Croasdale, Myrle. "Work force study tackles specialty vs. primary care." American Medical News 11 April 2005: n. pag. Web. 29 Mar 2010. http://www.ama-assn.org/amednews/2005/04/11/prsb0411.htm
James Artvantes of AAFP interviews physicians to get their ideas on the shortage issue:
Artvantes, James. "Primary Care Physician Shortages Can Be Traced Largely to Pipeline Issues, Says FP." AAPF 23 Sep 2009: n. pag. Web. 29 Mar 2010. http://www.aafp.org/online/en/home/publications/news/news-now/professional-issues/20090923medpac-pcps.html
Margaretann Cross of Managed Care Magazine gives more incite, along with graphs, about the shortage of primary care physicians in America:
Cross, Margaretann. "What the Primary Care Physician Shortage Means for Health Plans." Managed Care Magazine Jun 2007: n. pag. Web. 29 Mar 2010. http://www.managedcaremag.com/archives/0706/0706.shortage.html
This is an awesome, fairly recent article pertaining to the shortage of primary care givers:
Carmichael, Mary. "The Doctor Won’t See You Now." Newsweek 26 Feb 2010: n. pag. Web. 29 Mar 2010. http://www.newsweek.com/id/234218