Primary Care: A Shrinking Specialty

I just read an article showing the number of practicing primary care physicians per 100,000 population. Twenty two states have 55 to 77 primary care physicians per 100,000. Twenty three states have 78 to 100 primary care physicians per 100,000. Six have 100-124 per 100,000. Then there’s lone Washington DC with 244 physicians per 100,000 population - almost five times the number of practicing primary care physicians per 100,000 population as some other states. Maybe that’s why our lawmakers aren’t as concerned with health care issues — they don’t feel the effects of the physician shortage in Washington.

To put things in perspective, if every person in a given state’s population has a primary care physician, a state that has 100 physicians per 100,000 population, has one physician for 1000 patients. If a physician works 2000 hours per year (40 hours per week x 50 weeks), the physician spends 2 hours per year with an average patient. Even if a physician works 60 hours per week for 50 weeks per year, the doc only gets to spend 3 hours per year with the average patient.

In states with 55 physicians per 100,000 population, the hours spent with each patient shrinks to 1-1.5 hours per year.

In rough terms, given our insurance premiums, each member of my family pays $2,000/year for insurance - not including deductibles. We had one hospitalization last year after my daughter ate a poison mushroom (costing $11,000 before insurance, about $4500 after insurance discounts). Otherwise just routine physician visits.

The other family members get two hours with a physician each year for $2000.

I’m not sure which concerns me more - the fact that there are so few primary care physicians that they can only allot an average of 2 hours to each patient per year, or the fact that our family pays $1000 per hour plus copays for those visits and the physicians might get reimbursed $120 for them.

I admit that this is an oversimplification.

But it scares me nonetheless.