I wanted to comment on Stephanie’s post about the Medical Bureaucracy and new problems that are created by the new heath plan in the United States. I found this article that does a good job talking about the problems facing primary care within the new reforms:
“The 2009–10 health reform effort has addressed two interrelated crises: declining health insurance coverage, and high and rising costs. A third crisis also has captured the attention of policy makers: the decline of primary care.”
Basically not enough med students are choosing to go into primary care, and therefore the primary care doctors are being swamped. With fifteen minute appointments, how can doctors possibly effectively do their jobs? How is this different from societies that have socialized health care? How does this relate to SES?
5 thoughts on “Primary Care Crisis”
Hey Alessandra –
I love this post because I studied abroad in Denmark, where the Welfare State defines everything from salaries to childcare to healthcare. I was studying healthcare systems while there, and learned a lot about primary care versus secondary and tertiary care. In Denmark, the primary care physician is much more respected, and they act as gatekeepers to secondary and tertiary care. Here, if I want to see a dermatologist, for example, I can call him/her directly; no one is supervising the system, and joe shmoe is free to determine the type of care he needs for himself. I interviewed a primary care physician in Denmark who said that if patients treated her like patients treat doctors in America – constantly asking for a second opinions and questioning diagnoses – she would tell them they can no longer be her patient….much different from here, as I’m sure you know 🙂 I think we would see a big change in the system if we start actually listening to primary care physicians, and as you said, this may start with a longer appointment, so that the provider can accurately assess the situation.
Well primary care doctors are definitely swamped in Canada. I don’t miss waiting 3 hours to see one. I honestly believe a simple co-pay would probably take care of it as you definitely have a lot of habitual visitors with pretty minor concerns. My parents have health issues and their many visits are often warranted but they go plenty for nothing, visits they may have reconsidered if they were forking over 20 or so bucks every time. But probably that is an oversimplification. I will say that spending 1 month in the US without any health coverage at all was the single most frightening thing I’ve ever been through. I’d say it’s worth the 3-hour wait. Really.
Today when people decide what kind of medical doctor they want to be, I feel that there is a stigma or at least less impressiveness attached to being a primary care doctor. When one of my friends announced that she wants to be a family care doctor in rural Maine, the looks she received were converging on shock, horror, and bewilderment. Why do people make these judgments? We all need family doctors!
This is really interesting. My dad is a gastroenterologist (it took me a few years to learn how to pronounce and spell this) and he is disappointed with the health care plan right now, mainly due to its lack of attention to the practice of doctors. They are going to be overworked, underpaid, and without diminishing patient gratitude accompanied by increasing lawsuits, I don’t see how becoming a doctor will be as rewarding as it used to be.
I think Amy’s interview involving a doctor from Denmark turning away patients that challenge her diagnoses is so interesting. This would never happen in the US – or at least it would not be at all likely to happen. I think that Melissa also points out a good point – the 3 hour wait is better than the constant worrying. But is the current bill really working against the evils of our health care system? I don’t think so.
This was really interesting, my family told me about the transition from Europe to the States and the fact that when they were first here, they too didn’t have any health insurance. Which created burdens, especially when it came to thinking about starting a family and figuring out how everything would work. Luckily they assimilated well into society and got jobs that relieved the burdens of health care. But I agree with the wait to see doctors, beggers can’t be choosers at that point.