According to the American Medical Association, roughly two percent of medical students are entering primary care internal medicine. That’s an alarming number say medical experts who fear a lack of adequate compensation and ability to even pay back hefty medical school loans is keeping students away from family medicine.
The fomula used to pay doctors is based on a system developed by a Harvard economist 20 years ago called relative value units or RVUs. It is a point system that tabulates points based on how much training a doctor has or what kinds of equipment is used or procedures are performed. Theoretically the more procedures and higher tech equipment involved in the patient’s care, the more the docotor can bill.
Specialty doctors like cardiologists and radiologists tend to have no problem garnering rvu’s, but primary care physicians can’t seem to add up enough to make it worth their while these days.
The average medical student comes out of medical school with anywhere from $140 to 200 thousand dollars in medical loans. While specialists can command salaries of up to $500 thousand dollars annualy, primary care physicians might make around $190 thousand dollars a year .
Considering the workload, the cost of doing business and the cost of living period, many medical students are shaking their head and looking into more specific fields.
There has been an effort to revamp the rvu system over the years to level the playing field, but it is a small part of the overall healthcare debate on Capitol Hill. There is however a group called the Meidcare Payment Advisory Commission, which among other things is recommending a one time bonus to primary care physicians to entice future doctors…but no word on whether that will be adopted by any government panel.
Until then many in medicine are concerned that primary care physicians will become a dying breed, even still those who acknowledge the need to update the reimbursement system, caution moving too fast, at the risk of harming the patient in the end.