Primary Care Docs Going Out Of Business

A piece in the Seattle Times (picked up from LA Times) rings a harsh bell.  The front line of family medicine, the Primary Care Doc is an endangered species.  Or at least the business model is.  Read the lead . . .

The morning’s last patient, a disabled woman on Medicare, trails her doctor into her office and confides that she doesn’t have money for lunch. Tanyech Walford pulls out her billfold and hands her $3. It’s money the doctor really doesn’t have.

“I tell patients I’m broke, and they just chuckle,” she said. “They don’t believe me.”

Walford’s fashionable medical suite in a sleek building in Beverly Hills was hiding a grittier reality: She spent much of her lunch hour that day in her office opening mail — hoping to find payment checks to help fill the gap between her expenses and her revenue.

She hadn’t drawn a paycheck for herself since February. On top of that, her practice has cost her $40,000 in personal savings and left her with $15,000 in credit-card debt. Walford, 39, also owes $80,000 in medical-school loans. She shops at Ross and other discount retailers, and she rarely eats out or takes time off.

“I’m totally stressed out,” Walford said. “How can I take care of my patients when I’m that stressed?”

Walford is not alone in her struggle. Relatively low earnings, rising overhead and overwhelming patient loads are sending veteran primary-care physicians into early retirement and driving medical students into better-paying specialties, creating what the New England Journal of Medicine recently called a crisis.

The mystery in health care is everywhere you look, individual actors and firms are apparently losing money, yet the sector as a whole grows at insane rates and now accounts for a scary percentage of our GNP. 

One thing is absolutely clear, the days of the small private practice are simply over.  Rent an office, buy the equipment, hire a nurse and someone to do the billing, pay the insurance, argue with the payors, wait forever to get your money . . . it’s a horrible business. The business model is dead, head directly to a clinic.

More to the point, why would anyone want to be a GP.  You go to school forever, the cost of your education would buy a small country, Residency is a horror, and then you get beat about the head and shoulders by the payors while dealing more and more with patients who can’t pay anyway? 

All I can say is Go Obama.  This thing needs changing and right now.

Tags: HealthCare, Primary Care Doctor, New England Journal of Medicine, Obama