Pondering Change: Healthcare Shortages in My Town

So far, 2008 has been a roller-coaster ride for the medical community in my neck of the woods. Some of the major events:

1. Three primary-care internists closed their practices at the beginning of the year. Their mostly geriatric patients are still in the process of finding new doctors.
2. A local prenatal care provider also closed her office. She practiced with two midwives, and between the three of them, delivered 25-30 babies every month. The majority of her clients have transferred their care to my clinic, where we have five prenatal care providers but are only used to 12-15 births per month. Now we are facing 35-40 babies per month through the summer months.
3. A family doctor who specialized in pain management also closed his practice. His pain patients, many of whom receive primary care at other offices but rarely saw their PCPs, are now re-establishing pain management contracts with these PCPs. Because the pain specialist practiced--shall we say--beyond the comfort level of the rest of the medical community here, the influx of his former patients has been causing a lot of distress among the rest of us.
4. Two hospitalists have resigned from my group, making it impossible for us to provide 24/7 coverage for our community hospital. Solutions are being proposed, but none of them look promising

Remember when you were a medical student and you thought your job was going to be showing up at the clinic or hospital and seeing patients? You thought the only sacrifices you were going to make were long hours, sleepless nights, and exposure to bodily fluids. Right? Wrong! The biggest sacrifice I've made recently is the investment in time/anxiety/energy/earning potential towards solving the shortages above, especially #2 and #4. I've spent more time attending meetings, rewriting contracts, generating call schedules, and preparing payroll than I have staying current with CME this year. Didn't get paid a dime for all that work, and I'm certainly no smarter.

I'll take bodily fluids any day. More anon.

Comments

[Theresa]

Hi Dragonfly--good luck with OB rotation, hope you catch a lot of babies. It is still a peak experience for me.

Hi FD--Good to know there are other FP Hospitalists blogging out there. I know how you feel about OB. One of the reasons I haven't contemplated giving it up is I would miss it terribly once it was gone. I might appreciate the extra sleep, however. Linking to you, too.

[Fat Doctor]

Found you through twitter, and so glad I did. It seems we family med hospitalists are few and far between. I'm so impressed that you still do OB. I miss it. And the kids. Do only adult care now.

As for worrying about the health care situation, I assure you it is not a rural phenomenon. I live and work in a major metro area and I think about this issue many times a day.

Part of being a doc is caring -- you can't just ignore the system that is falling apart, because that would mean not caring about the patients it affects.

Linking to you, my dear.

[Dragonfly]

And with the bodily fluids...you can change your clothes and shower them off (though some smells do seem to linger more than others).