| | | As you know, as of a few months ago I no longer have a horse in this race, but... AMA doesn't restrict the numbers of docs and has very little say on the subject. There is a practically unlimited supply of docs from all over the world, and we can get the best of the best among them. The bottleneck is in the shortage of slots in "approved" training programs.
A study done a few years ago showed that only 2% of 4th year students in American med schools were planning to spend their careers in Primary Care. The field was basically annihilated by Medicare - which, in its wisdom, decided to pay primary care docs relatively far less than they pay hospitals and specialists. And - you get what you're paying for - expensive hospital and specialist based care.
PAs and NPs are going to discover that not everything that shines is gold. Their practice costs will be similar to that of MDs, and reimbursements - probably about the same or a little lower.
The notion that a good Internist or Family doc does not represent added value will hold only for those who, basically, don't need doctors - and only for as long as they don't need them.
Incidentally, some of the best and smartest PAs and NPs I met weren't even interested in Primary Care. They preferred to work for Cardiologists, Nephrologists, and (even) Neurosurgeons. They are smart - it's easier to learn a narrow field. Primary care seems easy, but it's much harder. |
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