I don't want to be a doomer, but the crash is here and it's going to get worse. The Virginian-Pilot and Daily Press have published numerous columns and letters about the deterioration of medical care. This was the worst treatment I've seen in 40 years, and appointments sometimes took up to a year. Numerous problems plaguing American health care have gone unnoticed and unaddressed.
I wrote in November 2022 (“The shortage of new physician trainees is irrational and solvable”) and November 2023 (“The shortage of physician trainees continues to cost lives”). I wrote a guest column explaining the critical shortage of specialist and primary care physicians. Unfortunately, no significant steps have been taken to rectify this abhorrent situation.
I read a recent article calling for an increase in Medicaid reimbursement. This is a good start, but refunds need to be increased across the board. And if we don't have enough doctors, we can't help the patients who still suffer.
What are the elements of this perfect storm? These include a shortage of health care providers, sleazy reimbursement for health care providers, and politicians who pay little attention to the overall health care environment.
Primary care physicians can receive insurance reimbursement of as little as $15 for an electrocardiogram. A complete blood count will reimburse him for $7.70. The equipment required for these tests can cost thousands of dollars. We have no control over the insurance company's reimbursement and it is significantly less than the cost of the physician providing the insurance.
Why should we care? Independent activity is becoming extinct. Few primary care physicians pursue that path because they can't pay off their student loans.
Have you ever wondered why surgeries performed in hospitals are so much more expensive than those performed in private clinics? The public can learn this by looking at the reimbursement providers receive . Politicians need to pay attention to the suffering of their constituents. They also need to pay attention to the middle class, which is being squeezed to death.
There is a need to monitor insurance companies and make their reimbursements public. They need to be held accountable for refusing necessary tests and procedures. Many providers no longer offer the test due to the losses incurred. This is dangerous and bad medicine.
Ironically, given current scientific advances, we need to have the best medicine available. However, technology is meaningless if it is not available. What can you do?
Write letters and call your local and national representatives like I did. Encourage national media to report on this critical shortage. Politicians have to do their job. We cannot pass laws, but we can pass laws. They really need to think about what matters and matters to the people they serve, rather than a host of other, sometimes wasteful, expenditures.
Can you imagine a politician being able to save lives? Well, it can. The federal government needs to fund 10,000 to 15,000 more trainees to produce thousands more primary care physicians and specialists. States may allow board-certified associate physicians with a medical degree to practice under another physician while waiting for a residency position to become available. . Some states have already done this, but Virginia has not yet done so.
Additionally, if a company or individual wants to limit or control your health care, they should have the same responsibilities as your doctor. Some coverage decisions regarding medications and diagnostic tests (such as stress tests and his CAT scan) are made with impunity. If an outside authority can deny you proper medical care without ever seeing you, that authority should be held accountable. I wake up and smell Betadine.
Glenn R. McDermott, MD, is the medical director of the Minor Acute Care and Family Care Center and assistant professor of clinical internal medicine at Eastern Virginia Medical School in Norfolk.
