I agree - primary care physicians are relatively underpaid compared to other physicians - which is making it harder and harder to recruit new physicians into PCP training programs. There are some other reasons, too. The capital costs of running a "modern" practice are high- for instance it can cost $50K or more per physician to acquire and install electronic health records. Most med school graduates have enormous student debt, and therefore need to find a salaried job, as opposed to going into "private" independent practices. When older physicians who are the owners of independent practices want to retire - they are most likely to sell out to either hospitals or private equity because no one else will pay them as much for their practices, and the junior partners cannot afford to buy them out.
There's not a straightforward solution, but better antitrust enforcement could help, and many commentators feel that at the top end we need some sort of price caps so that hospital delivery systems cannot use their leverage to increase total reimbursement to unreasonable levels.
The excess cost of proceduralists being acquired by hospitals or by private equity companies is substantially higher than the cost of PCPs being acquired.
Maybe we should look at why this is occurring. If PCPs were reimbursed for the services they provide including caring for their patients maybe they would not feel the economic need to sell out to a system. We have a serious reimbursement disconnect for providers that needs to be fixed or we will continue to have irrational behaviors
I agree - primary care physicians are relatively underpaid compared to other physicians - which is making it harder and harder to recruit new physicians into PCP training programs. There are some other reasons, too. The capital costs of running a "modern" practice are high- for instance it can cost $50K or more per physician to acquire and install electronic health records. Most med school graduates have enormous student debt, and therefore need to find a salaried job, as opposed to going into "private" independent practices. When older physicians who are the owners of independent practices want to retire - they are most likely to sell out to either hospitals or private equity because no one else will pay them as much for their practices, and the junior partners cannot afford to buy them out.
There's not a straightforward solution, but better antitrust enforcement could help, and many commentators feel that at the top end we need some sort of price caps so that hospital delivery systems cannot use their leverage to increase total reimbursement to unreasonable levels.
The excess cost of proceduralists being acquired by hospitals or by private equity companies is substantially higher than the cost of PCPs being acquired.
Thanks for the comment!
Maybe we should look at why this is occurring. If PCPs were reimbursed for the services they provide including caring for their patients maybe they would not feel the economic need to sell out to a system. We have a serious reimbursement disconnect for providers that needs to be fixed or we will continue to have irrational behaviors