Your Voice: Afraid for future of primary care

The report from The Physicians Foundation that you mentioned in “Physicians walking away from traditional roles as dissatisfaction grows (Vitals, November 25, 2016)” is the most telling and saddest commentary that can be made on the profession of medicine.

That 48% of 17,000 doctors surveyed planned to retire, cut back on hours or seek administrative positions because of burnout, low morale and pessimism about the future of medicine is almost unbelievable.

Hard to understand how this came to pass. To some extent medicine is a victim of its own successes.

Modern procedures and medicines are expensive, medical liability forces doctors to practice defensively; patients have been led to believe that doctors ought to be perfect and medical errors and complications are not supposed to occur.

To make matters worse, it is impossible with the many regulations imposed by government and insurers and the sophisticated electronic equipment to deal with them for doctors to be able to afford to practice independently.  

To survive, they must align with large medical groups or hospital networks. And either way, they find that their judgment as how to best care for an individual patient often conflicts with the guidelines enforced by their employer.

All of this is incompatible with the spirit of independence and individuality that doctors depended on to get them through the rigors of medical school and residency.

My prediction is that there will always be a need for medical doctors as teachers and to do complex hospital procedures, however nurse practitioners (NPs) and physician assistants (PAs) will be taking over many of the tasks that physicians are currently doing.

It will be quicker and cheaper to train NPs and PAs. More of them will enter the workforce and the workload per individual will be much less as will be the burnout and dissatisfaction that is plaguing physicians.

Having more providers on the workforce will greatly increases access to the health system and emergency room won’t be over-taxed acting as primary care centers.

But, as Montaigne the essayist famously said “What do I know?”

Edward Volpintesta MD

Bethel, Connecticut