A Chance to Cut is a Chance to Cure mentions a Medical Economics article about jobs in primary care, and how Internists are (in some markets) in greater demand than family physicians. Hospital systems greater interest in Internists"… is partly a byproduct of employers' current focus on recruiting specialists" according to one of the recruiters quoted in the MedEc article.
Well .. we family physicians can be a bit .. uh .. thin-skinned about this sort of stuff, so please forgive me if I seem a bit negative about the post for a few reasons:
I am disheartened that rather few internists are attracted to primary care.
I am disheartened that some recruiters and "hospital systems" are drawn to Internists rather than family physicians due to a perception that Internists drive more specialty referrals. Business is business, I suppose. So if the goal of a hospital system is to drive referrals .. and increase utilization of highly reimbursed services (such as surgery), then I suppose these concepts are right on target and we all should nod our heads in agreement.
Yet I wonder if this all misses the point. Why are we providing healthcare? Is the primary goal is to earn money .. and healthcare is the market? (Just like selling cars or baseball hats or computers) .. I sure hope not. As a profession, we do what we do because we want to deliver a valuable service to the world.
Yes – we want/need to be reimbursed – or we couldn't sustain the service. But reimbursement isn't the primary goal. And if we consider the goals (implied, perhaps) of family physicians – I would suggest that they coincide with the healthcare needs of a community better than most other physicians.
Yet employers of physicians are sadly more interested in the financial picture than the healthcare needs of a community.
- They need to build demand for their service by hiring an Internist rather than a Family Physician. Wow.
Let's change a few words and see how similar that is to:
- "General Motors needed to build demand for their cars by killing off public transportation.
Yeh .. I'm streching the analogy a bit .. but .. you get the point .. is healthcare about "increasing market segment" or about "meeting a community's healthcare needs?" I argue that the two are inherently at odds. Physician supply and recruiting remarkably DOES change healthcare. Yet these "market force" decisions will hurt us far more than they will help us in the long run. We need a system where the skills of physicians trained and recruited will meet the healthcare needs of a community – not the fiscal needs of a hospital or healthcare entitiy.