To all these people that say, “talk to your doctor about…”: how many people out there actually have a family doctor who they can call up and just have a chat with? I sure don’t. In 10 years, I’ve never found a doctor that wasn’t booked out for months and so busy that an assistant comes in the room to do most of the talking. You see the doctor for maybe 5 minutes and they’re so burned out they barely listen.
We’ve known about this doctor shortage for at least 10 years (even before the ACA) but do you know who’s to blame for this massive shortage of doctors? The American Medical Association working with the Federal Government at least as far back as the 1980s. After reports came out that “a glut of doctors” were on the way. You see, people figured out that being a doctor paid well, so greedy capitalists had entered the profession to provide a needed service and make some money. This would eventually bring down salaries so the number of graduates, residences, and licenses in any particular year were intentionally restricted to protect the established providers (who were, btw, largely white, affluent, and older; if you care about that).
So as we’re going through this situation and the mostly “progressive”, mostly middle- or upper-class, non-minority people (you know, the one’s who talk about all the injustice) are saying, “just talk to your doctor and you’ll make the right choice,” remember that it’s their progressive policies that f*ck’d the entire medical system in the first place. They’re the ones that have consistently made it harder to find an affordable doctor or a medical service that’s cheap and easy to find. The problem has never been the free market or personal choice. The problem is the government and it’s mandates that come along in the guise of protecting the public.
Your mention of finding an affordable doctor reminded me of this Adam Ruins everything segment I’d seen before. https://youtu.be/CeDOQpfaUc8
That’s mostly about pricing, which is a different, also terrible issue.
This access is largely part of the urban/rural divide as well, I have an amazing PA who I meet with twice a year for 30 mins to an hour, go over any questions/issues I have, do blood work, etc.
I also think this article makes a good point, it’s that primary care medicine just doesn’t pay the same as specialized medicine. Therefore most med students are choosing to specialize, and when it costs $200-300k to complete their education I can’t really fault them for going for a specialty with the biggest ROI.
https://www.usnews.com/news/health-news/articles/2021-03-23/shortage-of-primary-care-doctors-is-costing-american-lives
The issue I’m angry about is much older than that. Check out this article from 1997 where the AMA advocates limiting the number of total doctors because ‘most people are on HMOs and NPs and PAs do the work.’
https://www.nytimes.com/1997/03/01/us/doctors-assert-there-are-too-many-of-them.html
Besides that, they say most new docs will just move to suburbia and take jobs away from established providers. Either way, the government almost exclusively allows the AMA to regulate this industry, so when their projections were COMPLETELY WRONG and when the financial interest of the AMA ran contrary to the needs of the industry, we end up with situation we have today. And that only fuels the distrust that people have when they look at the kind of messaging that’s coming from the government during the pandemic.
I think our family has been lucky (mostly). My doctor and the kids’ doctor are available almost at any time. I can send a nonurgent question online and get a response within 24 hours (usually less!) We have on-call services too for when they get sick. I talk, at length, with my PA and my kids’ doctor when we visit.
I know a few PCP doctors personally and can tell you they would generally be happy to spend more time with their patients addressing their issues and getting to know them. The reason they don’t is not because they feel there aren’t enough doctors to go around (many would be PCP docs wind up as hospitalists or attending physicians at hospitals and urgent care clinics due to industry pressures) because the industry has been profit motivated to minimize face to face time and maximize patient throughput. Quotas and productivity incentives mean your doctor is if not directly required to minimize interaction with you then at least incentivized to. If they don’t we all know there’s a good chance they’ll be replaced by someone who will.
I think there was a conflict on Scrubs over something like this where Dr. Kelso wanted beds turned over quickly to make room for patients that would get the hospital more money.
This post wasn’t about any particular doctor doing wrong. Every doc that I’ve ever known has had their heart in the right place. But we’re short by something like 50,000 doctors in this country. That kind of shortage overburdens every remaining doctor in the industry. The profit motive was working to correct this at least as far back as the 70s, but the government and the AMA have been artificially restricting the supply of new docs. Even today they are actively fighting against other trained providers from performing any role that has traditionally been performed by an MD. Anything that could take some burden off doctors would be a blessing for the industry, but the collusion between the doctor’s cartel and the government is too strong.