Legal Commentary

The vanishing primary care physicians

By Tom Kirkendall

This earlier post on my internist's decision to adopt a concierge health care model for his practice noted that the economic crisis faced by most primary care physicians was one of the primary reasons for the change in his practice. In this recent post, Kevin Pho passes along the story of yet another internist hanging up the stethoscope as a result of not being able to make ends meet within the frazzled U.S. health care finance system:

"I am an Internist for over 20 years, and I recently closed my primary care practice as I cannot make a living at it. I made $23K in the last 11 months. And, my departure from practice is only the beginning of a tsunami of closures of primary care practices . . .

Primary care is unraveling around us. Indeed, all of the articles about the inordinate strain & crowding of emergency departments across the U.S., overlook the obvious - the impending failure of primary care is going to completely overwhelm emergency rooms. There is no way to prepare for this other than to save primary care.

The whole house of cards has begun to collapse, and all the articles and discussions fail to put it in terms with sufficient emphasis. All of the 'universal' systems that actually work are built on very strong and well-funded foundations of primary care. Everything else in health care is built upon that foundation, and that is precisely what is failing across the country. Why are emergency rooms overcrowded? Why are the wait times increasing even for the seriously ill? Because primary care is failing!

Just remember, I told you so."

And here is another primary care physician's analysis of why he turned to the concierge model.

Full post as published by Houston's Clear Thinkers on January 25, 2008 (boomark / email).