April 22, 2009 03:25 am
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We were reminded the other day of the importance of family doctors — now and in the past — with the passing of Dr. Theophil Sobol, who practiced medicine in the Village of Keeseville for 31 years. Doc Sobol was 91.
He was the epitome of the country doctor: took and developed his own x-rays, set broken bones and practiced a lot of other procedures for which, today, a patient needs to see a specialist. He made house calls and was available pretty much 24 hours a day, seven days a week. He was unerringly dedicated to his craft and loyal to his patients.
The primary-care physicians of today are still the front line of the medical field. Yet, the number of new family doctors around the country is dwindling.
A recent series of published articles found that as many as one in five Americans doesn't have a family doctor. Issues of access and affordability almost inevitably yield a shortage of primary-care physicians. And, the series concluded, that translates directly to higher rates of illness and death and higher costs.
It also found that counties with more primary-care physicians had significantly lower death rates than those with fewer family doctors. Further, they also had lower death rates from detectable and preventable diseases, such as heart disease and many cancers. And for treatable high blood pressure, the difference in death rates was 32 percent.
That said, there's little national health-care reform that will work unless the issue of the family doctor can be addressed. The best health insurance is of little help if there aren't frontline doctors to accept it.
A recent survey found that almost half of all primary-care doctors say they plan to retire or cut back their hours in the next three years. There are far too few to follow in their footsteps. Another recent survey found that only about 7 percent of today's medical students say they plan to pursue family care and only 2 percent of medical-school graduates trained in internal medicine plan to enter primary care.
Why? The pay is one reason. Primary-care docs are paid roughly half as much as specialists, which puts a crimp in trying to pay back student loans in a timely fashion. And Medicare, Medicaid and many private insurance companies don't pay for family doctors to take the lead in their patients' medical care or single visits dealing with multiple medical issues. Moreover, people entering the field of primary care work long hours with little if any backup.
And then there's the emergency-room option, an expensive alternative to having one's own primary-care doctor.
No one's going to fix the health-care system until the issue of fewer family doctors is resolved. There just aren't enough Doc Sobols to go around anymore.
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