Telemedicine and the PCP Cliff

Everyone on Capitol Hill seems focused on the so-called “fiscal cliff” – January 1st.  Not on the radar, though, is the rapidly approaching cliff involving primary care physicians, PCPs.

Everyone on Capitol Hill seems focused on the so-called “fiscal cliff” – January 1st.  Not on the radar, though, is the rapidly approaching cliff involving primary care physicians, PCPs.

According to a new study in the Annals of Family Medicine, when the ball drops in Times Square at midnight on New Year’s Eve 2024, the United States will have a shortage of 52,000 primary care physicians.  That sounds like a long way off – 12 years – but it takes at least four years to finish med school and one or two years to complete a residency.

The federal government and even some state governments are trying to entice med school students to consider primary care as a career, but once they’ve spent hundreds of thousands of dollars to get their medical degrees, most set their sights on the more lucrative specialties.  When you study the financials you can see why.

An Academic Medicine study suggests the benchmark for whether a newly trained physician can make it in primary care is a college loan debt of $160,000 or less.  Sounds like a lot, but nearly one in four 2011 graduates of private medical schools owed more than $250,000 the day they wore their caps and gowns.

Medical Economics reports these young docs will probably have to “live in a low-cost area or engage in some type of nonstandard loan repayment plan to avoid incurring additional debt in the decade after graduation.”  Now there’s something to look forward to!

The Centers for Medicare & Medicaid Services has typically dragged its bureaucratic feet.  Recent articles including one online at FierceHealthCare report CMS finally decided to increase Medicare reimbursements to family doctors and internists next year.  I’m wondering if it’s too little, too late, for that aspect of primary care.  A lot of doctors have talked about refusing new Medicare patients, and some have followed through on their threat.

Perhaps the momentum pushing us toward the edge of the PCP cliff can be slowed, but I doubt it can be stopped.  We must use the available tools that can make healthcare accessible.  Even in a future where PCPs are as scarce as Buffalo nickels, telemedicine can help keep costs in check while extending physician practices.  We have the proven technology.  Can we get the attention of decision-makers in time?