19 September 2013

Demand Continues for Primary Care Doctors

The demand for primary care doctors is here now and will for many years to come. With the demand for these doctors increasing in many rural or less doctor dense areas, recruiters cannot fill the needs. Merritt Hawkins, a national health care consulting and recruitment firm, speaks to some of the issues, but not all. This firm along with two other staffing companies spans the lower 48 states and includes rural and major metropolitan areas.

As we become more aware of the needs for doctors in the rural areas and many underserved areas of medicine, all three recruiting firms have found that hospitals and medical groups are continuing to seek primary care physicians, nurses, and assistants. However, this is the first year that the request for geriatricians out paced the demand of previous years. This is also the first time that this specialty has entered into the firms' top 20 of the most recruited.

Travis Singleton, senior vice president at Merritt Hawkins, stated that, “It is interesting that our youngest doctors are treating our oldest patients, but I think that some of it is just reclassification, it was happening already.” Other specialties, such as radiology and anesthesiology, despite being among the most competitive and desired positions a decade ago, did not make the top-20 list for 2013.

Dr. Atul Grover, an internist and chief public policy officer at the Association of American Medical Colleges, says, “I think people are starting to look at the market and get nervous, because of Medicare payment changes that impact doctor's pay and the growing emphasis on preventive medicine.”

I think the “growing emphasis on preventive medicine” has many doctors making changes because they are afraid of preventive medicine and know little about it, after having practiced only treating people already ill or in need of treatment for a disease or chronic illness.

I have been made aware of two towns about an hour and one-half distant of recently loosing two primary care doctors because their agreement with the towns had been fulfilled. Both headed for hospitals in larger cities where they will become hospitalists and at a much higher wage and less hours.

Many doctors are taking different jobs to satisfy a work-life balance and not the hectic almost 24/7 hours and paperwork of meeting the needs of their current jobs. According to the three staffing firms, hospitalists ranked third on the top 20 list.

Even with the health care law's attempt to curb the high cost of emergency care, Merritt Hawkins reports an increased demand for emergency department (ED) doctors. With patients finding fewer primary care doctors available to meet their needs, patients will continue to turn to the ED as a last resort or for convenience.

This points out the increasing need for doctors to be trained that will serve in vulnerable communities and the need for incentives for them to continue to practice in these communities. However, the doctors that left these communities for large cities continue to lobby to prevent NPs, PAs, and Pharmacists who have remained in these communities from being able to practice unsupervised.

Therefore, it will be necessary for patients in these underserved areas to lobby their state legislatures in opposition to the state medical boards. Also these same patients in some communities to will need to lobby for restrictions on telemedicine to be lifted. The next decade will be interesting as the powers that exist now may see their popularity disappear and be replaced by the very groups they are muzzling now. And, I feel that the patients may play a large part in this.

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