Hottest Job in Healthcare Still Primary Care Physician

John Commins, for HealthLeaders Media , August 28, 2013

Part of the reason for the current shortage of family physicians harkens back to the perception in some medical circles just a few years ago that primary care was a specialty best to be avoided unless you wanted to work long hours for less pay.

For the seventh straight year family physicians topped the list of the 20 most sought-after specialties for recruiters Merritt Hawkins.

This should not surprise. It has been evident for the last several years that as healthcare reform eventually mandates a shift away from fee-for-service and rewards prevention, quality outcomes, and population health, primary care physicians will lead the way.

Another driver for the high demand is the growing numbers of service sites. Medical groups searching for primary care physicians increasingly find themselves competing against other medical groups, hospitals, community health centers, urgent care centers, retail clinics, academic centers, and government facilities.

It was fashionable in the 1990s and the Health Maintenance Organization era to refer to primary care physicians as "gatekeepers" who would map out and coordinate care strategies to reduce costs and waste. While the gatekeeper label might have gone out of fashion (or conjures up unpleasant thoughts of rationed care) the role clearly has come storming back.

Return of the Gatekeeper
"Everybody wants to be in primary care. The whole mantra with healthcare reform is wherever your patients are let's be there," says Kurt Mosley, vice president of strategic alliances at Irving, TX-based Merritt Hawkins.

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1 comments on "Hottest Job in Healthcare Still Primary Care Physician"

J. Kuriyan (8/28/2013 at 3:40 PM)
In the early days of managed care there was the assertion that "90%" of all medical costs were routed through the PCP - making the PCP a most powerful player in managed care. Not challenging the actual percentage, the point was simply that in managed care all care is channeled through the PCP gatekeeper. This made some of the PCPs quite arrogant in their dealings with specialists in their IPAs and PHOs. Others even formed companies like PHYCOR that had only PCPs as owners. The trouble was that the trillion dollars that PCPs were indirectly responsible never really passed through the PCPs office - and there was never an opportunity to retain even a small part of it. In fact various versions of the Stark Law prohibited any self-aggrandizements. Meaning, PCPs were just tasked with referring the money out to others - clearly not a very powerful piece of the puzzle that was managed care. They continued to toil and they made very little, as before, except now they even have management responsibilities. Repeating the same program won't work any better. What is needed is a way to fully compensate PCPs for preventive care programs - and that will truly be an extra souce of income. Currently wellness programs for big companies cost in excess of $1000 per year. Compare that with what a PCP gets paid by a managed care plan - $200 per year!If part of that $1000 can be paid to a PCP then we will truly see PCPs making a decent wage. But the insurer's won't like that. They'll claim that prevention is part of what PCPs are supposed to offer - and the $200 they get covers it adequately!




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