This
Doximity story has resonance for health care everywhere especially LMICs,
Nigeria inclusive, who have greater Human resource challenges than others: READ
ON'
What
Happened to All the Family Medicine Physicians?
Health
eCareers · October 16, 2017
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SUMMARY
POINTS:
·
The people I knew in med school who wanted to go into family practice — only
two or three in my 100-person class — were definitely a more compassionate
breed, seemingly uninterested in the money and high profile that were drawing the
rest of the class toward specialties.
·
the median income for family medicine physicians in the U.S. is $185,000,
compared to $275,200 for oncologists, $312,000 for dermatologists and $350,000
for cardiologists
·
family medicine doctors and other primary care physicians are over-worked?
Concentrating the more complicated cases on a family medicine physician’s
schedule while still expecting them to churn out the same number of patient
visits in a day is only going to further the over-worked, burned-out family
practice problem.
·
The best family medicine physician is someone who spends a good deal of time
counseling patients about their health, and they can’t really take time to do
that effectively if their schedule is tightly packed. Preventive health is
extremely important from a population health standpoint, but it’s not
compensated fairly.
·
Closing the pay gap between primary care physicians and specialists, and fixing
our healthcare system!
FULL TEXT
Demand for
family medicine doctors is at an all-time high, as confirmed in Health
eCareers’ Q1 2017 Healthcare Recruiting Snapshot. Experts in the
industry believe that this demand is due to a variety of factors, including the
Affordable Care Act’s focus on primary care and preventive medicine and the
fact that a good number of primary care physicians are reaching retirement age
at the same time that med-school graduates are choosing to specialize, instead.
But there’s
another compelling reason, too. Study just about any healthcare salary chart
and you’ll see that it’s sad but true: Family Medicine physicians are
always listed at or near the bottom. According to the Health eCareers
Salary Center, the median income for family medicine physicians in the U.S.
is $185,000, compared to $275,200 for oncologists, $312,000 for dermatologists
and $350,000 for cardiologists.
So we
decided to find out: Why aren’t more med students choosing to become primary
care physicians? Is it solely because of the relatively low salary, or are
there other contributing factors? We asked Tyler Friedrich, M.D., a hospitalist
in Denver, his thoughts on the subject:
Health
eCareers: What are the reasons for the disparity in salaries between
primary care docs and other specialists?
Dr.
Friedrich: While there is an argument to be made for pay being tied to
length of training — cardiologists, orthopedists and other highly paid
specialists usually spend six to seven years or more in residency, versus three
for primary care — the difference in pay is not in proportion to this at all. I
think it’s partly because, under our current healthcare model, there is no way
to bill accurately for preventive care. Despite physicals and other such visits
taking much longer than, say, a skin biopsy, they’re only reimbursed a fraction
of the amount of procedures like that. Until our healthcare system catches up
with the rest of the developed world in terms of incentivizing preventive
health, I’m afraid this isn’t going to change.
Health
eCareers: So that’s why more and more med students are choosing to
specialize?
Dr.
Friedrich: Yes, that’s what I’ve noticed. While $185,000 is a very nice
annual salary, if you have med-school loans to pay off, the higher-paying
specialties are definitely more attractive. I also think vanity and prestige
contribute to this. I’ve been asked many times, “Don’t you want to specialize?”
— as though this should be the default aspiration. The people I knew in med
school who wanted to go into family practice — only two or three in my
100-person class — were definitely a more compassionate breed, seemingly
uninterested in the money and high profile that were drawing the rest of the
class toward specialties.
Health
eCareers: How do physician assistants and nurse practitioners figure into
this?
Dr.
Friedrich: The emergence of advanced-practice providers (APPs) such as PAs
and NPs is a bit of a double-edged sword in primary care. Family practice
providers are definitely over-extended, given the shortage, frequently seeing
more than 20 patients per day. APPs can help offset the workload, for sure. The
issue is that they provide a cheaper alternative for healthcare organizations,
salary-wise, and this decreases any leverage the physicians might have to try
and close the pay gap. Plus, APPs usually get to see the more straightforward,
healthy patients, such as well-woman or well-child visits, leaving the doctors
with the more complicated cases that take a lot longer than their scheduled
appointment time.
Health
eCareers: You’re saying, then, that family medicine doctors and other
primary care physicians are over-worked? Is that also contributing to the
shortage?
Dr.
Friedrich: Absolutely. Concentrating the more complicated cases on a
family medicine physician’s schedule while still expecting them to churn out
the same number of patient visits in a day is only going to further the
over-worked, burned-out family practice problem. The best family medicine
physician is someone who spends a good deal of time counseling patients about
their health, and they can’t really take time to do that effectively if their
schedule is tightly packed. Preventive health is extremely important from a
population health standpoint, but it’s not compensated fairly.
Health
eCareers: So, what’s the solution then?
Dr.
Friedrich: Closing the pay gap between primary care physicians and
specialists, and fixing our healthcare system! ‘
Joseph Ana.
Africa Center for Clin Gov Research &
Patient Safety
@ HRI West Africa
Group - HRI WA
Consultants in
Clinical Governance Implementation
Publisher: Health and
Medical Journals
8 Amaku Street Housing
Estate, Calabar
Cross River State, Nigeria
Cross River State, Nigeria
Phone No. +234 (0) 8063600642
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