Abraham Verghese is a professor of medicine at Stanford University and one of the most articulate physician-writers today. He recently wrote an op-ed highlighting primary care’s plight, and focuses on the scarcity of time:
The science of medicine has never been more potent – incredible advances and great benefits realized in the treatment of individual diseases – yet the public perception of us physicians is often one of a harried individual more interested in the virtual construct of the patient in the computer than in the living, breathing patient seated on the exam table.Time is the scarcest commodity of all. Patients, particularly when it comes to their routine, day-to-day care, want a physician who has time to understand them as people first, and then as patients.
There’s no easy answer, and worse, money isn’t even the root of the problem. Often left unaddressed is the burnout that primary care doctors face, practicing in unpalatable environments where the doctor-patient relationship is obstructed by bureaucracy and paperwork. Read more »
*This blog post was originally published at KevinMD.com*
Dr. Wes (a cardiology blogger whom all should read) wrote a very compelling post about technology and the bondage it can create for doctors:
The devaluation of doctors’ time continues unabated.
As we move into our new era of health care delivery with millions more needing physician time (and other health care provider’s time, for that matter) –- we’re seeing a powerful force emerge –- a subtle marketing of limitless physician availability facilitated by the advance of the electronic medical record, social media, and smartphones.
Doctors, you see, must be always present, always available,always giving.
These sound like dire words, but the degree to which it has resonated around the Web among doctors is telling. Read more »
The Wall Street Journal reported that overall medical use fell as patients had fewer doctor office visits, lab testing, and maintenance medications possibly due to the recession or as a result of consumer-driven healthcare in the way of higher deductibles and copays. This is very worrisome.
Certainly patients should have some financial responsibility for their care, but skimping on care will only result in Americans not becoming healthier, but sicker. Though the article cited some examples of patients saving money by not seeing their allergist for a refill of medication and simply calling for one and getting an athletic physical at a local urgent care clinic for $40 rather than $90 at the doctor’s office, these tiny behavior changes aren’t going to bend the cost curve in medical care. Read more »
With medical students graduating, on average, with almost $160,000 of debt, it’s a major reason why they’re choosing more lucrative specialty practice, which can offer salaries multiple times more than those of primary care fields.
In this clip from The Vanishing Oath, medical economist Amitabh Chandra, Professor of Public Policy at the Harvard Kennedy School of Government, discusses that influence, which contributes to a drastic decline of primary care residency slots being filled by American medical graduates.
Of course, it’s not only money. Primary care practice has a litany of obstacles that can contribute to rapid physician burnout, compounded by the fact that good primary care role models are largely absent from academic settings.
But there’s no denying that the salary disparity is an influential factor, and for many students, often a deciding one.
A video excerpt from The Vanishing Oath, a film directed by Ryan Flesher, M.D.:
*This blog post was originally published at KevinMD.com*
According to studies, as reported in the Wall Street Journal, it’s a mixed bag:
Physicians as a group are leaner, fitter and live longer than average Americans. Male physicians keep their cholesterol and blood pressure lower. Women doctors are more likely to use hormone-replacement therapy than their patients. Doctors are also less likely to have their own primary care physician—and more apt to abuse prescription drugs.
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