Young Docs Shun Primary Care

The last time you tried to book an appointment with your primary care physician, how far out did you have to schedule? Do you even have a primary care physician?

The shortfall would be anywhere between 12,500 to 31,100 primary care physicians by the year 2025.

It’s getting tougher and tougher to not only find one still taking new patients, but to find one in general.

“If the system for delivering primary care in 2020 were to remain fundamentally the same as today, there will be a projected shortage of 20,400 primary care physicians,” the U.S. Department of Health and Human Services wrote in a 2013 report.

In 2015, the AAMC offered a revised estimate that the shortfall would be anywhere between 12,500 – 31,100 by the year 2025. Given physician training can take up to a decade, the recommendation was to address the situation by 2015 or the shortfall will be even greater.

An aging population is said to be partly responsible for the rise in demand, but also contributing to the challenge is the focus on specialized medicine. Medical students simply aren’t going into primary care anymore.

One first-year resident, Avir Mitra, wrote an insightful piece on the issue for The Pulse this week. He wanted to know why, after going into med school to help care for patients long-term, he found himself specializing in emergency medicine.

Mitra found himself talking with Colin West, a primary doctor and professor of medicine at the Mayo Clinic in Rochester, Minnesota. West is also a prominent researcher on the economics of primary care. West said the pipeline for primary care physicians has really slowed down. “As a result, today only roughly 30 percent of physicians practice primary care, compared to 70 percent 50 years ago.”

That has a lot of primary care residency slots going unfilled. And when primary care is considered the “front line of medicine” because these are the doctors who care for the whole patient, not just a specific part of the body — what are patients to do?

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“That’s important because, without primary care, there’s no one really tying it all together. It’s like a great team with no quarterback. Without a primary provider, no one is coordinating. No one is seeing the whole picture,” West said.

He added that subspecialty-driven care without primary care coordination is more expensive.

A lack of respect for primary care doctors within the medical profession itself, low pay and an “insane amount of paperwork” are several other reasons Mitra listed as to why good people and smart doctors don’t even consider the field.

Related: Patients vs. Paperwork: How to Help Young Doctors

“In 2015, the average primary doc made $195,000 — which, from my perspective, is a lot. But the average orthopedic surgeon made $421,000. Now, if you think about going through four years of college, then four grueling years of medical school, then three to six years of soul-crushing residency and coming out well into adulthood with a mountain of debt — while all your friends have retirement accounts, and be looking at a salary that’s potentially only a third of what someone who goes into a subspecialty can expect to make? Well, that would make anyone think twice,” said Mitra in the Pulse.