Comments on: Primary Care Physician Shortage

By: Grewgills

Grewgills — Fri, 02 Nov 2007 16:40:24 +0000

Massachusetts we have the most general practitioners per capita of any state, doctors have the lowest income of doctors in any state, and we have among the most expensive health-care of any state.

Would you link to where you got that information? StateMaster has a ranking of physicians per capita by state, but no breakdown of gps per capita by state. I have not been able to track down a good state by state comparison of md income. StateMaster also has a good comparison of Gross State Product and Health Spending as % Gross State Product. Massachusetts ranks 13th and 45th respectively. This does not likely place MA "among the most expensive health-care of any state."

By: spencer

spencer — Fri, 02 Nov 2007 14:17:10 +0000

While all the national data is correct, in Massachusetts we have the most general practitioners per capita of any state, doctors have the lowest income of doctors in any state, and we have among the most expensive health-care of any state. Given this prime example of the exact opposite data, sure makes one questions the conclusions of the analysis.

By: dutchmarbel

dutchmarbel — Fri, 02 Nov 2007 01:11:29 +0000

In the Netherlands the general practitioner serves as a gateway and the referral system keeps the costs down.

My GP can make appointments for me with emergency room if necessary (so I don't have to wait, has happened with kids and when husband had broken his wrist), and in my town our hospital has a GP post near the emergency room. You call the 'doctors line' and they either give you an appointment with the GP post (for that evening) or check which emergency room has lowest waiting time. Which means even emergency's rarely take more than an hour and a half, two hours, including getting there and back.

By: floyd

floyd — Fri, 02 Nov 2007 00:46:39 +0000

The common HMO requirement of seeing specialists only with a referal from your "primary care" physician only exacerbates the problem. It should be revisited and modified to some extent.

By: dutchmarbel

dutchmarbel — Thu, 01 Nov 2007 21:33:20 +0000

It's not just more slots in Universities. Training doctors takes time from other doctors too. When there is allready a shortage and workload is high, it is hard to make enough time to train and educate new doctors, and before you know it you're spiralling down in a vicious circle.

The US allready has a high percentage of foreign trained doctors (about a quarter are foreign born, majority works in this field), but that also means that they profit from the resources other countries spend in training.

By: Dave Schuler

Dave Schuler — Thu, 01 Nov 2007 16:15:51 +0000

Still, even if we build more medical schools and get more market competition into physician pricing, we’re not likely to totally reverse the incentives to go into more prestigious and lucrative fields. Still, it would certainly help.

Specialists have other problems such as needing to go where the jobs are. Here's a PowerPoint presentation showing the relation between the relatively small numbers of primary care physicians in the U. S. and the U. S.'s low level of outcomes compared to other OECD countries. Check slide 20. This article highlights the point I've been making for some time: we shouldn't be thinking in terms of training 20% more physicians (that would put us on par with France on a physicians per 100,000 basis). We should be thinking in terms of educating 200% more physicians. Or changing the work rules to achieve a similar result.