Tuesday, December 25, 2012

Does U.S. Need General Practictioners and Specialists?

West Virginia needs medical specialists
Being No. 1 in diabetes deaths shows a need for endocrinologists

FOR years, West Virginians have been told that they need family doctors and not those expensive specialists. Marshall University has become a national leader in producing family physicians.
That is laudatory. Properly compensated, rural physicians can serve the state well.
But West Virginia must also have specialists. It leads the nation in cancer deaths and deaths from diabetes and is No. 2 in deaths from chronic lung diseases.
There are shortages in certain specialties, such as endocrinology, that the state needs to address.
West Virginia would be a natural for an endocrinologist because there are so many people with advanced diabetes and other diseases of the endocrine system.
But while demand for such specialists has increased, the compensation has not. Many if not most of the sickest people in the state are on Medicaid or Medicare, government-run health programs that do not adequately compensate specialists.
Also, endocrinologists have smaller patient loads because they must devote more time to treating individuals.
"You make less money as an endocrinologist than you would as a general practice physician," said Dr. Joseph Shapiro, dean of Marshall's medical school. "Why would you want to train more to make less?"
That is especially true given the expense of medical school, which often leaves new doctors with student loans of $100,000 or more.
Dermatologists also are in short supply for a different reason. The Accreditation Council for Graduate Medical Education allows West Virginia University's dermatology residency program to accept only one student each year.
"It's an underserved specialty that's fiercely protective of its domain," Shapiro told Zack Harold of the Daily Mail.
Reducing barriers to competition and increasing government compensation would go a long way toward improve medical care in West Virginia.
Discouraging specialists to save money would hurt West Virginia patients. That's not good medicine.

My opinion:
I guess this reveals all sides of the issue.  The bottom line is that, overall, we need more doctors of all specialties, and certain sections of the country may need certain types of doctors more than other sections.  Furthermore, I think the shortage is especially severe in rural areas.  I was not aware that some specialists don't make more than general practitioners - I thought endocrinologists made plenty.  Maybe only in certain areas.  I did understand, though, that dermatology is one of the most competitive specialties out there.  Is it time to approach the accreditation councils and ask them to accept more residents?  I believe they are already doing so, but frankly, I'm not so sure that we'll end up with enough doctors across ANY specialty.  Feel free to comment.

No comments:

Post a Comment