The Houston Chronicle reported that in the last two years, about 350 Texas doctors have dropped the Medicare program. In 2008, 62 percent of those doctors were primary care physicians. Something similar is happening with Medicaid, the government health insurance program for low-income individuals and families.
In the age of lower reimbursement rates, specializing may be a more attractive option for medical students than going into primary care. Would a solo practice trend encourage more medical students to enter into the field and hang out their own shingles?
NPR is running a three-part series on primary care physicians going solo. An excerpt of part one:
Conventional wisdom is that the age-old model of a single doctor serving patients out of a small office is rapidly going extinct. Doctors need to evolve or die. That means fancy new computerized medical systems and bigger groups to handle the overhead.
But Cathy Crute wants to get one thing straight from the get-go: She is not a dinosaur.
“No, no. I think patients love a small practice,” she says from her rather Spartan office. “My receptionist can recognize a lot of patients’ voices over the phone. They know who they’re talking to every time. They don’t have to go through a whole chain of command.”
And the patients in the waiting room of her Portland, Maine, office seem to agree with that assessment.
“I just think it’s better service to come to the same person all the time and have one person overlooking you,” says Laurie Warhol, from nearby Waterboro. She’s been coming to Crute for more than a decade. “I think they know you better. They know your problems better. You don’t have to remind them of everything all the time.”
Patient Mike Greenleaf says he likes not just the doctor, but the entire atmosphere of the practice. “The staff’s great, and they know you on an individual basis. And it just makes you feel that much better than if you just go sit in a room full of people and have someone call your name that doesn’t know you,” he said.