Fifteen years is a long time … for just about anything. With respect to medical trends, it’s an eternity. Nineteen ninety-four is when I graduated medical school. Gleeful at the prospect of completing a family medicine clerkship and residency (as well as my geriatrics fellowship), I could hardly wait until that magical time came — upon completion of my post graduate training — I could “hang my shingle” and join the wave tsunami that was the surging interest of family medicine as a discipline in the middle- to late-1990s.

At that time the infamous, and now dead, “gatekeeper” model of healthcare delivery was in full swing, as health plans and staff-model organizations never held back rewarding primary care doctors for the “efficient” navigation of patients through the healthcare marketplace. Third parties, like the insurance companies, were capitalizing in a major way through the funneling of patients to what they deemed appropriate care paths which led to significant profits for their efforts — at the same time creating an undue burden to the lowly family doc whose workload became increasingly burdensome and trite. 

Then came the backlash.

Now it’s 2009. Primary care docs are saddled with lower reimbursements on all fronts (public and private), lower job satisfaction, and (relatively) lower pay. Here’s hoping the recent news of a private sector $2T stimulus at the hands of Pharma, Insurance, and major healthcare organizations in response to President Obama’s reform goals will help revitalize the necessity for primary care in a healthcare marketplace which currently rewards procedure over art. You don’t need a physician who has been practicing over 10 years to tell you this. Many of those who are about to enter my profession for the mere privelege and future satisfaction of it can also explain it quite well. | LINK

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