Original Source

CNN.com/health

Updated November 18, 2008 0929
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Half of primary-care doctors in
survey would leave medicine

by Val Willingham
CNN Medical Producer
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(CNN) - Nearly half the respondents in a survey of US primary care physicians said that wthye would seriously consider getting out of the medical business withing the next three years if they had an alternative.
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The survey released this week by the Physicians' Foundation, which promotes better doctor-patient relationships sought to find the reasons for an identified exodus among family doctors and internests widely known as the backbone of the health industry.
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A US shortage of 35,000 to 40,000 primary care physicians by 2025 was predicted at last weeks American Medical Association annual meeting.
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In the survey, the foundation sent questionaires to more than 270,000 primary care doctors and more 50,000 specialists nationwide.
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Of the 12,000 respondents, 49 percent said they'd consider leaving medicine. Many said they are overwhelmed with their practices, not because they have too many patients, but because there's too much red tape generated from insurance companies and governemnt agencies.

And if that many physicians stopped practicing, that could be devastating to the health care industry.
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"We couldn't survive that," says Doctor Walker Ray, vice president of the Physicians Foundation. "We are only producing in this country a thousand to two thousand primary doctors to replace them. Medical students are not choosing primary care."
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Doctor Alan Pocinki has been practicing medicine for 17 years. He began his career around the same time insurance companies were turning to the PPO and HMO models. So he was a little shocked when ge began spending more time on paperwork than patients and found he was running a small business, instead of a practice. He says it's frustrating.
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"I had no business training, as far as how to run a business, or how to evaluate different plans," Pocinki says. "It was a whole brave new world and I had to sort of learn on the fly."
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To manage their daily work schedules, many survey respondents reported making changes. With lower reimbursement from insurance companies and the cost of malpractice insurance skyrocketing, these health care professionals say it's not worth running a practice and are changing careers. Others say they're going into so-called botique medicine, in which they charge patients a yearly fee up frong and don't take insurance.
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And some like Pocinki are limiting the type of insurance they'll take and the number of patients on Medicare and Medicaid. According to the foundations report, over a third of those surveyed have closed their practice to Medicaid patients and 12 percent have closed their practices to Medicare patients. That can leave a lot of patients looking for a doctor.
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And as Ray mentioned, med school students are shying away from family medicine in a survey publishes in the Journal of the American Medical Association in September, Only 2 percent of current medical students plan to take up primary care. That's because these students are wary of the same complains that are causing existing doctors to flee primary care hectic clinics, burdensome paperwork and systems that do a poor job of managing patiens with chronic illness.
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So what to do? Physicians don't have a lot of answers. But doctors say it's time to make some changes, not only in the health care field, but also with the insurance industry. And they're looking to the new administration for guidance.
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One of President-elect Barack Obama's health care promises is to provide a primary care physician for every American. But some health experts, including Pocinki, are skeptical.

People who have insurance can't find a doctor, so suddenly we are going to give insurance to whole bunch of people who haven't had it, without increasing the number of physicians he says. "It's going to be a problem."