With the alarming shortage of primary care physicians facing the United States, one has to wonder if Nurse Practitioners and PAs are going to represent the new Primary Care providers.  This is already one of the fastest growing segments of the healthcare industry and with the continuing shortage of family practice, internal medicine, and pediatricians, one can assume that it will not be changing anytime in the near future.

What is the answer to the shortage?  Well, some say more money but how much more and how do you force the commercial insurance industry to comply with standards adopted by Medicare.  There currently is no regulation specifically requiring commercial insurance companies to follow the guidelines produced by CMS.  So even if CMS does what many have suggested and increase the physician fee schedule for Medicare, what makes anyone believe that commercial insurance carriers are going to just fall in line.

I hope for the sake of our healthcare system that we come up with a solution fast or we are going to be in for a rude awakening as the wait times and locations continue to dwindle.

Is anyone else confused at the position of the American Medical Association regarding ObamaCare?  It would seem as though they are a very poor representation of their members.  But the fact is that the recent house bill has thrown huge incentives at Physicians by doing away with the SGR (Sustainable Growth Rate Formula) which was due to give physicians a 21.5% decrease in Medicare payments in January.  It has been coming up with decreases every year for the past 4-5 years but every year it is stopped by the AMA or other lobbyists.  Anyone practicing Medicine knows that the Medicare reimbursements are barely enough to cover the costs of doing business so any cut to Medicare would be far felt.  The doing away of the SGR is a big win for the AMA so it does not surprise anyone when they offer their support.  The House bill also contains an allocated 5% increase to primary care physicians(Finally) which has been needed for a long time.

The problem with the AMA’s support is that the Bill still is devasting to our national deficit and long term sustainability.  With a Medicare system that has been operating in the Red for years, how can we expect the government not to come up with a balance that debt in the coming years.  What you will have is a healthcare system revolving around the government.  40% Medicare, 60% obamacare.  The House bill does provide some serious incentives but you have to question the naked man who offers you his coat.

There are many physicians out there wondering what is going on withe proposed health plans and how any of them will affect them.  Internal Medicine physicians, Family Practice Doctors, Pediatricians, and Hospitalists seem to have the most at stake in this evolving health plan.

Primary Care physicians are already in high demand and the country has been facing a shortage of doctors providing general care for many years.  This is only going to get worse as their pay continues to lessen and demand continues to increase.  You are seeing more and more urgent care facilities because Emergency doctors and other practitioners are leaving their traditional practices behind and seeing patients on a cash basis thus circumventing the insurance red tape(for the most part).  This is very attractive for many reasons but once everyone has insurance, will this model remain.

You have to ask yourself what will happen to the system when people are given health insurance.  Health insurance that has not costed them anything therefore how much could they possibly care about protecting the system.  There is not an easy answer or an answer that everyone will be happy with.