Grow primary-care doctors

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An investment in more doctors and more residency slots, as advocated in The Augusta Chronicle (“A real medical emergency,” Dec. 28), is necessary, but not sufficient to address the state’s evolving health-care needs.

The challenges of our current health-care system – including high cost, variable quality, insufficient access and persistent disparities experienced by rural, low-income and minority communities – clearly demonstrate that increasing the number of providers won’t automatically translate to better care.

Building the health-care workforce that Georgia needs will require targeted investments in primary care and in developing a more diverse medical workforce that reflects the diversity of our state. Primary-care health provider shortage areas exist in 126 Georgia counties. Numerous studies have demonstrated that health systems with a strong primary-care foundation provide better outcomes at lower costs. In spite of the increasing diversity in our state, minorities remain underrepresented in the medical work force.

Minority physicians are more likely to care for underserved populations, practice in low-income communities and choose primary-care specialties.

A targeted strategy focused on primary care and diversity will help build the medical workforce that Georgia needs.

Harry J Heiman, M.D., M.P.H.

Eddie J Turner, M.D., M.P.H.

Atlanta

(The writers are members of the Satcher Health Leadership Institute at the Morehouse School of Medicine in Atlanta.)

Comments (17) Add comment
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desertcat6
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desertcat6 01/19/12 - 04:07 am
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And your solution is? What

And your solution is? What targeted strategy is going to fix this, and how much is it going to cost the tax payer? Of course pursuing private donations to establish a scholarship fund could work too.

carcraft
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carcraft 01/19/12 - 06:33 am
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Physcians are going bankrupt

Physcians are going bankrupt because of decline in compensation from medicare and medicade. Does it sound like a good idea (if you are a Doctor) to go to an under served area that will cause an unfavorable payer mix ( insured via large insurance group verses medicare or medicaid) resulting in an increased likelyhood of bankruptcy?

bjphysics
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bjphysics 01/19/12 - 06:42 am
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carcraft: “Physcians are

carcraft: “Physcians are going bankrupt because of decline in compensation from medicare and medicade.”

Data?

Techfan
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Techfan 01/19/12 - 06:54 am
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As an RN for 18 years, I can

As an RN for 18 years, I can attest that I have seen ZERO doctors close or go bankrupt in or around hospitals where I have worked.

agustinian
666
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agustinian 01/19/12 - 07:22 am
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If you want more primary care

If you want more primary care MDs you need to pay them for their expertise. When MDs enter residency they quickly figure out that if they want to earn good money they need to subspecialize (Dermatology, Nephrology, Rheumatology, Gastro-ent, etc.) because third party payers (insurance, medicare, medicaid) don't value the time and efforts of primary care physicians.

BTW, what the !#$!@#$ does race have to do with it. I want the best qualified, most committed physicians. If they are all minorities, great, if they are white, great. We aren't one week out from MLK day, and we still want to value people by the "color of their skin" instead of the "content of their character." Diversity is just another euphemism for race quotas, and I am just tired of it.

justthefacts
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justthefacts 01/19/12 - 07:32 am
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Some are leaving practice

Some are leaving practice others are just refusing to take Medicare patients. If you are 65 and need a new physician..good luck.

Techfan
6461
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Techfan 01/19/12 - 08:03 am
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If your over 65 and need

If your over 65 and need insurance and there isn't Medicare, good luck.

Riverman1
78408
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Riverman1 01/19/12 - 08:17 am
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Again, it comes down to the

Again, it comes down to the residency problem. Primary care physicians have to do a residency, too, of sorts. If you provide the slots and make it easy to transition into a practice when they finish, they will stay. The problem is physicians don't want the competition of new practices.

Here is the point few get into because medical education is such a big money game. Medical schools are controlled so tightly that it's almost impossible to start new ones. Smaller schools would thrive because applicants now can't find schools currently.

For those who say the quality of the physician wouldn't be as good from a lesser med school, we already use a large percentage of physicians from foreign med schools. They all train in American hospitals for their residency.

If a student can passs the the Foreign Medical School Graduate exam he can work in this country. Why not make it easier to start med schools in this country and control the whole process with a similar test?

Carleton Duvall
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Carleton Duvall 01/19/12 - 08:29 am
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Reimbursement from

Reimbursement from Medicare/Medicaid to primary care doctors is certainly inadequet. That does not mean that they are going bankrupt, however, but they are entitled to a better level of payments for the service they provide. For that reason more medical school graduates are going to other specialties leaving a shortage in the primary care field. I have no data, BJ, to support this observation . I have learned this as a frequent patient and discussing this problem with the doctors that I visit.

bjphysics
36
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bjphysics 01/19/12 - 08:47 am
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Carleton, I’ll buy that

Carleton,

I’ll buy that observation; also, a citation is a good thing to have but you don’t need it to make a rageous [sic] statement just an outrageous one.

Carleton Duvall
6305
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Carleton Duvall 01/19/12 - 09:34 am
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Good, BJ. I am glad that we

Good, BJ. I am glad that we are on the same page with this matter. I would rather have you on my team than on the other guy's.

harley_52
21747
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harley_52 01/19/12 - 12:07 pm
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Citations are generally

Citations are generally pointless and worthless in a forum like this.

If you search long enough and hard enough you can usually find "proof" of both conflicting sides of any issue. And 'Climategate' taught us the worthlessness of "peer reviewed" studies and articles in proving much of anything.

These boards are generally a bunch of laymen offering their opinions and their experiences. Trying to make them some sort of scientific review board is a folly.

soldout
1280
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soldout 01/19/12 - 02:18 pm
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Was this a problem before we

Was this a problem before we had medicare or has it made it worst?

Carleton Duvall
6305
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Carleton Duvall 01/19/12 - 03:06 pm
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soldout, Medicare became law

soldout, Medicare became law in 1965 which is over 45 years ago. I doubt if you could say whether Medicare is responsible for this problem or not. Certainly, an aging populace has added to the problem as that has created a larger demand on primary care. I imagine that you can find a number of opinions as to what effect Medicare has had.

allhans
22970
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allhans 01/19/12 - 03:27 pm
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I have two regular doctors,

I have two regular doctors, a primary care and a specialist. Both have large signs posted at the front desk: NO NEW Medicare patients. That speaks louder than any words we use on here.

bdouglas
4236
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bdouglas 01/19/12 - 05:45 pm
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"BTW, what the !#$!@#$ does

"BTW, what the !#$!@#$ does race have to do with it. I want the best qualified, most committed physicians. If they are all minorities, great, if they are white, great. ... Diversity is just another euphemism for race quotas, and I am just tired of it."

I agree wholeheartedly with this statement.

bdouglas
4236
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bdouglas 01/19/12 - 05:51 pm
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@allhans: I have a primary

@allhans: I have a primary care and a specialist as well. Both accept Medicare as far as I know. At the primary care office I often have to wait a *minimum* of an hour after my scheduled appointment before I'm even taken back to a room. Lord knows how long I have to wait after that point. No less than 30 minutes at least.

At my specialist (an allergist) I often wait no more than 5 minutes past my appointment time and no more than 5-10 minutes to see the doctor once I've been checked out by a nurse.

This also says a lot about the situation. The primary care provider seems forced to take in more patients than they can see in a day and force the rest to wait and force the doctor to stay late. Is that by choice or by corporate policy? I don't know. But what I do know is that if I'm coming down with a sinus infection I will call my Allergist before calling my primary care doctor, even though both are just as qualified to treat it. My insurance copay for a specialist ($50) is twice what my primary care copay is ($25), but my time is much more valuable to me when my Allergist gets me out at least an hour quicker than my primary care doctor will.

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