Adult primary care providers (PCP’s-Family Doctors and Internists) are paid 55% of what reimbursement is typically for specialists Yet, specialists (cardiologists, radiologists, surgeons, etc.) increase the cost of care, increase the number of hospitalizations, and utilize pharmaceuticals in greater numbers, DECREASE lifespan and quality of life. PCP’s, on the other hand, INCREASE length of life, DECREASE mortality and decrease all the other parameters I just mentioned like hospitalizations, unnecessary X-ray studies, etc. PCP’s are by consequence not as profitable for pharmaceutical companies, radiology testing facilities, laboratories, medical device manufacturers, etc. because they use less of these modalities. In the Bush administration, there was no encouragement professionally and/or financially for the lowly PCP to do his/her work. As a result, fewer and fewer PCP’s remain as medical students shy away from the underpaid and poorly respected primary care roles in training institutions. Existing PCP’s are retiring early, changing professions and leaving a vacuum that is endangering communities- urban and rural alike. PCP’s that remain and struggling to survive financially are seeing fewer poor, seniors and middle class patients by dropping participation in Medicaid, Medicare and commercial insurances to become “concierge” or cash doctors- catering to the rich only.
 
Sadly, the Bush administration and the Republican Party were deaf to the changes needed to protect PCP’s and halt their extinction. Now, great news! It looks like Medicare will be raising reimbursement for PCP’s while it begins to trim reimbursement for overpaid radiology, surgery and other specialties starting in 2009. In addition, funds will be increasing the training and retention of PCP’s. This will have a dramatic ripple effect within all insurance programs nationally that use Medicare as their guidepost for establishing their rates. Starting this year and looking forward the Obama administration has set in motion a striking and much needed shift in health care- bringing the status and the pay of the PCP in line with what should be. Congratulations!