An Argument Against Creating More Doctors

Primary care doctors are leaving their practices in droves, driven out by their low pay (relative to that of specialists), long hours and mountains of paperwork. Some of them go to work in emergency rooms or hospitals, others become specialists, and many simply abandon medicine. The idea that there’s a supply-side solution to this problem is a little like thinking you can fill a bucket with holes in the bottom by pouring in more water.

Full editorial on primary care doctors in The New York Times.

Comments (5)

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  1. Bruce says:

    Interesting point. Third party payers have so abused the practitioners in this market that the problem cannot be solved by adding more bodies.

  2. Tom H. says:

    I’ve not seen this argument made before. Clearly what is needed is a revolution in the way primary care functions. Probably should be along the lines of the kind of changes you have been advocating, John.

  3. Stephen C. says:

    One can believe that (a) we need more primary care doctors and (b) current payment schemes will eventually drive them away, without contradiction.

  4. Bart Ingles says:

    Won’t the physicians that remain be able to command higher fees? This seems to be a self-limiting problem.

  5. John R. Graham says:

    Specialists are not bailing out, just primary-care practitioners (PCPs), according to report.

    What I suspect is actually going on, economically, is that Mayo Clinic is establishing a queue-jumping function with the PCP consultation as “key-money”.
    Plus, maybe they share the $ with the specialists, but who knows?

    It is not a sustainable model, politically, because the government will observe that Mayo Clinic PCPs are getting their patients into the Mayo Clinic specialists and other PCPs are not. The cry goes up: “The Mayo Clinic is only for the wealthy, who can afford the primary-care fees, but they receive Medicare benefits for specialty-care. Unfair! Two tier! Either the whole Mayo Clinic must be in Medicare or none of it can be!”

    Pretty much like what happened in Canada.