Why is it hard to find a primary care doctor?

Exhaustion causes doctors to leave the profession.

read the book Doctor’s Stories Written by William Carlos Williams, who has burned through my mind the ways a Primary Care Physician (PCP) can transform patients’ lives with a careful blend of careful listening, emotional communication, and medical skill. This book inspired me to become a PCP.

According to a 2021 report from the National Academy of Sciences, Engineering, and Medicine, an increased supply of PCPs is associated with better population health and more equitable outcomes. With our country’s deteriorating health care system, it is essential to have a primary care provider who knows you, because it is nearly impossible to access any kind of coherent medical care without the coordination of the primary care provider.

The most common question I get asked as a doctor—by friends, acquaintances, relatives, patients’ families, and colleagues—is, “Can you help me find a PCP?” I do not print. None of us can. Why is it so hard to find a primary care provider nowadays?

Unfavorable demographics and PCPs leaving the profession

While the COVID pandemic has certainly pushed a large subset of already exhausted PCPs on the brink of near or full retirement, or into less stressful jobs, the current primary care crisis has been brewing for much longer. The United States is expected to face a shortage of 21,000 to 55,000 primary care physicians by 2033.

Both patients and doctors are getting older. As patients age, they tend to take more care of PCPs to address the prevalence of medical and medication problems that inevitably come with aging. At the same time, the Association of American Medical Colleges reports that more than 40% of active physicians in the United States will be 65 or older within the next decade. The American Medical Association notes that 29% of physicians retire between the ages of 60 and 65, and 12% retire before the age of 60.

These numbers have shocking implications for the future supply of seasoned doctors. Furthermore, a fifth of physicians say they are likely to leave their current practice within the next two years, and a third of physicians plan to reduce their hours within the next 12 months.

PCPs have higher depletion and lower pay than many majors

Primary care is hurting more than most specialties, due to lower salaries, high rates of burnout, and a growing sense that their job is generally impossible and thankless on all fronts. According to a 2019 medical survey, degrees of fatigue among PCPs were as high as 79%. Many hospitals are happy to replace PCPs with even lower-paid NPs and PAs, who do well with routine care but are not trained in the subtleties and intricacies, which come into play if you have a difficult or rare medical condition, or if you have many comorbidities. medical.

Multiple reasons for dissatisfaction with primary care

Many primary care providers face the demands of their hospitals to see more patients, who are getting worse and their care more complex each year, in the face of significant salary and benefits cuts as administrative and clinical support dwindles. Primary care providers have to do more with each visit, as new requirements and treatments emerge, but none of the work geared toward preventative health, such as managing blood pressure and cholesterol, as well as discussing and making requests for hospital scheduling for health checks such as mammograms, seems to go away. X-ray and colonoscopy.

Moreover, when patients are finally able to come in to see us in person, they have many unaddressed issues and concerns because they often haven’t seen us for a year or two. This creates a vicious feedback loop, with ever-growing problems for primary care patients under time pressure and patients with increasingly symptomatic and unmet medical needs.

Time allotted to electronic medical records affects fatigue

It is estimated that for every hour a primary care provider spends with a patient, up to two hours of work is generated, which includes writing summary notes and treatment plans in the patient’s electronic medical record (EMR) and communicating test results or other important information to patients and their caregivers. Many primary caregivers I know go home at the end of stressful days, spend an hour or two with their families, and then stay up late to finish all the computerized documentation their day at the clinic has created. Many also have second jobs or side gigs to pay off their medical school debt.

What we run in today’s clinics is increasingly complex and out of our control. While the entire health care system is struggling, getting patients to the emergency department, to the hospital, and making an appointment to see medical professionals is difficult. Primary caregivers are left to manage many things in the absence of the support we are normally accustomed to.

We also manage larger mental health needs and deal with the brunt of our patients’ problems, such as lack of housing and employment, unaffordable medication, and pervasive financial problems. The fact that we are not able to take care of our patients nearly as well as we once were is the ‘moral damage’ that many of us suffer. And there is research to suggest that when your doctor suffers in this way, the quality of your health care can be affected.

What can patients do to find a primary care provider?

If your current PCP has resigned or retired, ask the practice to assign you a new person. In theory, practices are not supposed to leave patients stuck and abandoned, even if, like many places, they do not have enough experienced physicians to care for patients appropriately. If that doesn’t work, or if you don’t feel your new doctor is a good fit for you, you can call your health insurance and see which doctors are accepting new primary care patients.

If you have a friend who is a doctor or nurse, perhaps they can advocate for you by asking a colleague to accept you into their clinic. Our system shouldn’t work this way, but it often does. Most clinics have waiting lists, so if you don’t have a primary care provider, put your name on it, because it’s better late than no.

What might reflect the primary care crisis?

We need to train and support more primary care providers financially by encouraging interns to go into primary care, and eliminating the pay gap between primary care providers and specialists. We need to support those physicians who are currently trying to hold on to them as primary care physicians, so that they don’t reduce hours or quit. These doctors urgently need emotional, financial, logistical and psychological support.

Finally, we need to implant the magic of primary care in new physicians, as William Carlos Williams so eloquently explained, so that people can, in fact, have access to the care that will enable them to live and enjoy the long, healthy lives that they deserve.

from San Jose News Bulletin https://sjnewsbulletin.com/why-is-it-hard-to-find-a-primary-care-doctor/