http://www.nytimes.com/2009/12/23/opinion/23brownlee.html?_r=1&ref=opinion"FOR anyone who has had to wait a long time to schedule a medical appointment, it might seem as if the world needs more doctors, and that training more of them would be a good idea. An amendment that teaching hospitals are pushing to include in the health care legislation before a final vote is taken in the Senate and the House would do just that. It would add 15,000 medical residency slots to the 100,000 residencies the federal government now finances, most of them through Medicare.
This amendment is being heavily promoted by several doctor specialty societies and the Association of American Medical Colleges, a group that represents the nation’s major teaching hospitals. But that doesn’t mean it’s a good idea. It would raise Medicare’s bill for residencies, which is already $9 billion a year. More important, since the cost of health care follows the supply of doctors, the added slots would substantially increase the national health care bill. And the measure would not address the underlying reason that patients are forced to wait to see doctors.
Over the past 20 years, the number of doctors in relation to the American population has risen by 30 percent. Yet in many parts of the country, more doctors has simply meant more doctors, not better access for patients, not better communication among a patient’s health care providers, and not better results. The truth is that regions with the highest number of doctors per capita tend to deliver lower quality care at a higher cost.
Increasing the number of doctors would make our health care system worse, not better, because the United States doesn’t actually need more doctors. What we do need is for primary care to reclaim its central role in the delivery of medicine, to provide the preventive care, chronic disease management and coordination of services that is lacking in so many parts of the country. Primary care doctors can help patients avoid unnecessary visits to specialists, hospitals and emergency rooms, thus lowering health care costs.
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This piece addresses a point of discussion that has popped up at DU, but from a different angle. I'm still processing my thoughts on this opinion. I definitely agree with the need for a renewed focus on primary care docs. On the other hand, I'd need to see a lot more data in regard to the authors' claim that we don't need any more docs in total.
I hope this spurs some constructive thought.
Cheers!
:hi:
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