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Primary Care Doctors Struggle to Keep Patients

March 28, 2009 07:30 AM
by Sarah Amandolare
The economic crisis has made it difficult for some patients to keep up with routine procedures, and left many doctors trying to stay afloat.

Primary Care Doctors Ask for Help

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A growing number of primary care doctors, determined to offer patients the personalized care of previous generations, have started offering concierge-like services. But idyllic as small, relationship-driven practices sound, they are not easy to maintain, particularly in the current economic climate.

More patients have put off elective and routine procedures to save cash, leaving primary care physicians with open schedules. Meanwhile, some emergency rooms and hospitals are inundated with patients who may have neglected their health for financial reasons. According to Chicago's Daily Herald, the recession is pushing more private practice doctors to approach "hospitals to ask for help in buying expensive equipment, or for increased pay for on-call services, or to be employed and cut expenses."

Dr. John Sage, a physician at a private family practice in Mount Prospect, Ill., "estimates business is off about 10 percent since the beginning of the year," according to the Daily Herald. Sage has also started offering 20 percent discounts to patients who've lost jobs and insurance.
Besides wanting to maintain personal relationships with their patients, primary care physicians who maintain their own practices are rebelling against "increasingly large and impersonal health care systems and their emphasis on the bottom line," according to the Minneapolis Star Tribune.

Background: Concierge medicine

Concierge medical care has also been criticized for perpetuating inequalities in medical care. The services are often only affordable to wealthy patients, The New York Times reported in 2005, prompting Representative Pete Stark, a California Democrat, to dub the concept "a new country club for the rich."

The dearth of primary care physicians seems to be the root of the problem. Patients can't receive the care they need when doctors are overwhelmed with too many appointments. Salon columnist and former chief of neurology at Mount Zion-UCSF Hospital, Robert Burton, M.D., writes, "What is needed is an understanding of the diverse, complex and often conflicting motivations prompting students into medicine in general, as well as determining which specialties to pursue."

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Related Topic: Hospital as personal assistant

Opinion & Analysis: Why primary care is fading

A March 2006 editorial in The Seattle Times addressed the unraveling of the primary health care system. "The main reason is that new physicians are not choosing to pursue careers as family physicians and general internists," for several reasons: declining reimbursement rates for primary care, skyrocketing student loan debts, and "the complexity of caring for an aging population."

Reference: Health guide

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