Comments on: What this patient needs is a doctor!

By: Tazo

Tazo — Sat, 20 Aug 2005 21:18:01 +0000

Good post. And of course, an old problem. An article I came across recently highlights the long-term nature of the issue pretty well, I think.

“Arrogance”
Inglefinger FJ. N Engl J Med. 1980 Dec 25;303(26):1507-11

By: m

Thu, 18 Aug 2005 04:40:46 +0000

nurse practioners can and will do the primary care job, murse training is a lot cheaper , nurse training is a lot quicker’

nurse practioners are doing primary care and will be the new medical providers. Complicated patients will be deferred to specialists while NURSE providers will do the more common less complicated care.

By: EMDoc

EMDoc — Tue, 16 Aug 2005 20:16:34 +0000

While the number of total patients that Dr. Russo is quoted as seeing in a year seems large,5000, if you work this out by the number of patients per hour it is about 3 if he is in the office 35-40 hours per week. On the contrary, in a busy express care unit in an emergency department I may be seeing 4.5 -6 patients in an hour. Certainly, the complexity of the issues may vary between his office and the express unit, but the issue is the same…is there enoough time and incentive to spend time discussing the patients condition with them. Personally, I think it is our duty regardless.

By: RGL

RGL — Tue, 16 Aug 2005 12:54:41 +0000

This is indeed a growing problem: so much information available to physicians and patients, so many specialists and superspecialists to deal with, yet so little time for the primary care physican and the patient to spend together, particularly in a setting described with this case.

Though overburdend and undercompensated, the primary physician still bears the responsbility of guiding the patient through the labyrinth that medical care sometimes has become. He is still best equipped to advice her on
treatment options and not leave her hanging in the wind. It’s a tough choice to spend this time at the sacrifice of having to see fewer patients, and of course less compensation.

Payment reforms supposedly were made in the early ’90s to make it more equitable for non-procedural phyisicians relative to their procedure-oriented counterparts, but that has not panned out. The problems are bound to get worse until something more is done to lure new physicians into primary care fields.