Why is this doctor struggling to find a primary care physician?

I’m a well educated patient, but I had a hard time finding a new primary care doctor in the Boston area after my long-time internist retired. Robust quality and patient experience measures exist, but they are not generally available to the public, at least at the individual physician level. I thought I was being savvy by seeking referrals from my doctor friends to their own primary care physicians. That turned out to be a bad idea, though, because they tended to see physicians in practices that make extensive use of mid-level providers and residents. Of course when a patient who’s also a doctor shows up, there’s no way they’re going to be seen by an NP or PA.

Despite my own troubles, I was surprised to see a blog post by an internist who’d relocated and was having trouble finding a new primary care physician. He asked friends but they were on health plans with different networks, and he consulted the woefully inadequate consumer tools but to no avail. His observation is that there should be better tools available to the consumer.

I agree, but I have to wonder about this doc’s networking and data gathering skills. As a doc it seems it should be easy to find out who’s good by:

  • Asking colleagues (or med school buddies) their opinions. If they practice with someone they should be able to tell if they’re any good
  • To find a primary care doc why not ask a specialist to recommend someone who provides high-quality referrals? That seems like the best path
  • Interviewing doctors

I get the point that consumers need better tools, but I don’t see why a doctor can’t get things figured out.

One thought on “Why is this doctor struggling to find a primary care physician?

  1. Roy M. Poses MD

    Most primary care physicians are forced to increase their “productivity,” that is volume of patients seen per unit time. One reason is payment policies from CMS and echoed by insurance companies that only pay a small amount per patient visit. Look here: http://hcrenewal.blogspot.com/search/label/RUC

    Another reason is that many physicians now practice as employees of large organizations, sometimes ostensibly non-profit hospital systems, sometimes for-profit companies, even at times owned by private equity firms. Such organizations may use drastic incentives to increase productivity, and may demand physicians worry more about the bottom line than patient welfare. Look here: http://hcrenewal.blogspot.com/search/label/corporate%20physician

    Under these circumstances, even the most dedicated and skilled primary care physician may find it hard to provide good quality care, or make good quality referrals. That is why even knowledgeable physicians may have a hard time finding a primary care physician in a position to practice they way he or she should.

    Reply

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