Health care overhaul expected to amplify Maine's doctor shortage
As coverage is extended to the once uninsured, observers hope regional medical schools are able to satisfy the growing demand.
By John Richardson jrichardson@mainetoday.com
Staff Writer
The University of New England was already planning to nearly double the size of its medical school in Biddeford.
First-year medical student Meredith Marcincin is evaluated by stand-in patient Heidi Conner after a mock physical Thursday at the University of New England in Biddeford. Maine’s supply of primary care doctors has been tightening for years.
Gregory Rec/Staff Photographer
Elisabeth DelPrete, D.O., center, chair of the University of New England’s department of family medicine, meets last week with first-year medical students to discuss the mock physicals in which they had just participated. Fifteen percent of Maine’s primary care doctors are UNE graduates with a doctor of osteopathy degree, said the medical school’s dean.
Gregory Rec/Staff Photographer
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Its timing couldn't be better.
The health care reform law signed last week by President Obama will extend insurance to more than 30 million uninsured Americans. In Maine, that means that about 140,000 people will soon be more likely to see a primary care doctor than wait until they're sick enough for the emergency room.
They might have to wait to get an appointment.
Maine already is in need of more primary care doctors, and the shortage was projected to get worse as baby boomers age and demand more medical services.
"There are about 100 unfilled openings for primary care physicians in the state right now," said Marc Hahn, dean of UNE's College of Osteopathic Medicine. The state also is in short supply of other medical professionals, including nurses, therapists and pharmacists.
"If we remained on the same trajectory that we were on before, we're looking at some challenges in meeting the demand," Hahn said. "Now, let's look at the fact that the 30 to 35 million (people) are going to get coverage. They'll all be in greater demand."
There are efforts, in Maine and nationally, to head off this health care crunch. The new reform law itself includes provisions intended to increase the number of doctors to take on all the new patients.
Maine's supply of family medicine physicians and other primary care doctors has been tightening for years.
One reason is that, nationally, the vast majority of medical school graduates are now going into specialties such as radiology or cardiology. Specialists can earn three or four times as much as primary care doctors, which is especially important when you start a career $200,000 in debt from medical school.
As a result, there have not been enough young family doctors taking over for the rising number of doctors reaching retirement age.
On the other side of the equation, demand continues to grow. Along with the availability of more medical tests and treatments, doctors and patients are more aggressive about preventive care as a way to avoid serious illness and expensive hospital stays.
Maine, meanwhile, is the oldest state in the nation, with about 14 percent of the population over the age of 65. In about a decade, one of every five Mainers is expected to be a senior citizen.
The situation in Maine right now isn't as tight as in some parts of the nation. Maine has 1.5 primary care doctors per 1,000 residents, compared with a national average of 1.2, according to Hahn.
But that doesn't mean it's easy to find a doctor or get an appointment.
"It's not unusual to have a three- to six-month wait, if a practice is accepting new patients at all. A lot of primary care physicians are full. They can't accept more patients," said Dr. Elisabeth Mock, a family doctor from Holden and president of the Maine Academy of Family Physicians.
The shortage has been more chronic in the rural parts of Maine, but it now exists statewide, the experts said.
Alyssa Eppich of South Portland said she sees her primary care doctor regularly to keep a close eye on her heart condition. It was easy to get an appointment until about a year ago, she said.
"Now, when I call to get an appointment with him, it can be up to two months to see him, unless it's an emergency," she said.
Expanding insurance coverage to more people could well make waiting times longer. That's what happened in Massachusetts after the state adopted a universal health coverage policy in 2007 and practices were flooded with new patients who had been avoiding doctors.
Maine is in a better position than most states when it comes to the expected surge of new patients because of health care reform. About 11 percent of Mainers are now uninsured, compared with about 15 percent nationwide.
"The impact of covering the uninsured may not be seen as much in Maine as in other places," Mock said. But, she said, "it is expected that primary care physicians will have an increased demand, and we're not sure how we're going to meet that demand."
Many see promise in a new model of primary care that involves nurse practitioners, physician's assistants and others taking on a larger role in the care. While widely favored as a way to contain costs, those professionals are increasingly in short supply, too.
The health care reform law will provide some help, according to physicians and others.
It includes a bonus -- 10 percent higher reimbursement rates -- for primary care physicians in rural practices. It also includes more subsidies for newly graduated physicians who work in underserved areas and additional money to expand care through community health centers, said Kevin Lewis, chief executive officer of the Maine Primary Care Association.
The association is working to lure more medical students into primary care medicine here, according to Lewis. It is even encouraging middle-schoolers and high-schoolers to consider the career.
Many hopes are riding on the University of New England and a new medical school program operated jointly by Maine Medical Center in Portland and Tufts University School of Medicine in Boston.
The Maine Med program offers a $25,000-per-year scholarship for students who promise to do part of their residencies in rural Maine, which expands services and encourages doctors to stay in the long term.
The school, which offers an M.D. or doctor of medicine degree, began teaching its first class of 36 future physicians last fall. Not coincidentally, 22 of the first-year students are from Maine.
"We believe if you attract qualified students from our own state, they'll stay," said Peter Bates, chief medical officer at Maine Medical Center and interim dean of the school. "We've shown there are a lot of smart, young people in Maine who would like to be in health care."
UNE, meanwhile, has shown it is possible to produce a new generation of primary care physicians.
It works to attract future family doctors and encourages residencies in rural Maine. Although it also has seen a growing number of graduates choose specialties, about 60 percent of its graduates still go into primary care.
Many of them also stay in Maine. Fifteen percent of Maine's primary care doctors, and 25 percent of those practicing in rural Maine, are UNE graduates with a D.O. or doctor of osteopathy degree, said Hahn, the UNE medical school dean.
Both the D.O. and M.D. degrees qualify a graduate for general practice.
"We're still attracting students who are interested in primary care," Hahn said.
In fact, the school had 3,400 applications for 124 slots in its newest class of medical students. The school is now planning to expand both faculty size and classroom space in order to increase the class size from 124 to 225 within five years.
"We saw the enhanced demand for our product," he said.
Staff Writer John Richardson can be contacted at 791-6324 or at:
jrichardson@pressherald.com
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Dr. Marc Hahn, D.O., is dean of the University of New England’s College of Osteopathic Medicine. Gregory Rec/Staff Photographer |
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71 COMMENTS
OldGuy said...
Expect the Mad Hatter's Tea Party to "comment" their usual negative misery about this story. The poor things never seem to like anything unless it's approved by Limbo and Becky.
March 28, 2010 at 12:47 AM Report abuse
mohonk said...
And the usual drivel from the Kool Aid drinkers
March 28, 2010 at 6:22 AM Report abuse
seward said...
Expect anyone considering Career as a Doctor to re-think that after passage of this monstrosity of a health care bill which does not include any Tort reform. Expect anyone foolish enough to become a Doctor to leave Maine to avoid paying the outlandish income taxes. Expect Old guy to get drunk on Kook-aid and Coffee Brandy.
March 28, 2010 at 7:50 AM Report abuse
Biddy said...
Doctors will still make an above average income and many dedicated people with the interest in serving humanity will enter the field. Education financing for all students needs to be made easier and especially for medical students. Negativity about this underscores the fact that some will go to any lengths to shoot down health reform. We should all worry more about our primary weaknesses in Science and Math about our young relating to this then the health reform law.
March 28, 2010 at 8:05 AM Report abuse
Sid1950 said...
There would not be a growing demand if the doctor's did not have their hands in the back pockets of the drug companies. This country is over medicated with dangerous drugs,and unnecessary medical tests being performed. If even costs money to die peacefully these days. Hospitals do not like it when a person dies at home.
March 28, 2010 at 8:36 AM Report abuse
Relax said...
What we will see is the difference between folks who see the glass near full or those who see it as half full. In essence, we need more HC professionals because more people will for the first time be able to afford to receive HC at all. That's really a good thing right? Democrats see this as the glass filling up. It won't be full until we have Universal Coverage. Of course the conservatives see this as a bad thing because the superior care and exclusive HC they once had "could" now be negatively affected. At least until more HC professionals start pouring out of our Universities. Look at the opportunities opening up in that field! More good news!
March 28, 2010 at 8:47 AM Report abuse
crackhead said...
What will you stinking liberals say when we vote these liberal pigs out of office in November? Can't brand TEA as just an isolated group of racists then. Vote for a Pig-ree. Its easier than getting a job...
March 28, 2010 at 8:49 AM Report abuse
Player said...
OldGuy is a one trick pony.Nasty comments with reference to Limbaugh and Beck. Just another PPH Olberman-clone. And then we have the apologist moonbats who will rationalize anything that has a "D" next to it, ie Biddy.
March 28, 2010 at 8:50 AM Report abuse
trisailer said...
Primary care doctors write prescriptions and bump you up to a spaecialist. More and more people are computer savvy these days and could be using the tecnology to monitor their own health and prescreen themselves. I had a run in with a stubborn sinis infection. I did everything that a doctor would have told me plus I got my own culture done at a lab $50)to determine the type of infection and thus choose the most effective antibiotic. I shouldn't have needed to go to the doctor to get the prescription for the antibiotic. Eliminate the need for doctors only to write prescriptions and you solve the doctor shortage overnight.
March 28, 2010 at 8:54 AM Report abuse
brightOne said...
"In Maine, that means that about 140,000 people will soon be more likely to see a primary care doctor than wait until they're sick enough for the emergency room." - - - - - - - - - - - - - - And this is bad news? When the economy improves soon as well, the tea leaves will shrivel up and blow away.
March 28, 2010 at 8:56 AM Report abuse
TrueConserv said...
This can't be true. How can this be happening? He promised that passing the bill into law would cure all these problems. But then he also promised that Gitmo would be closed by now and that we'd be out of Bush's war in Iraq. Does this guy keep ANY of his promises?
March 28, 2010 at 8:57 AM Report abuse
crackhead said...
Its now taxpayer/property owner/small business vs. moocher/minority/government employee Which one are you, Biddy?
March 28, 2010 at 9:02 AM Report abuse
trisailer said...
One of the things that this bill will do is track outcomes and allow us to begin to correlate treatments and outcomes. Back in the 80's more women were dying from the breast cancer treatment than the disease. Men are being over treated for prostrate symptoms based on the PST which is inaccurate. Far too many heart surgeries are performed. Very little cause and effect data is collected currently which makes it hard to modify treatment effectiveness. People need to learn more about their own bodies and how they work.
March 28, 2010 at 9:03 AM Report abuse
Doc said...
Passage of ObamaCare = longer waits to be seen and more rationing of care. They're in the process of hiring 170,000 IRS agents to make sure everyone buys health care insurance, yet no where have I seen anywhere that anyone plans to hire a single physician or nurse!
March 28, 2010 at 9:22 AM Report abuse
OldHippie said...
Doctors are not the only healthcare provider to be able to write prescriptions. Nurse practicioners and physician assistants also can. I'm not sure about RNs, but they may be able to as well.
March 28, 2010 at 9:41 AM Report abuse
Relax said...
Doc, Is bringing up the IRS the newest way to put fear into the hearts of Americans? Has Fox or Rush determined that the cries of socialism or communism just weren't getting any traction? As a good capitalist you must have heard of supply and demand. As the need for HC providers grows so will their numbers. That will happen with or without the assistance of state and federal government. People will see what’s emerging in the HC profession/jobs and start pouring into the field then out to the public to make the big bucks and provide us ALL a measure of good HC in geographical areas where there previously was nothing. More good news! Glass full or half-full. It may all be simply a state of mind.
March 28, 2010 at 10:10 AM Report abuse
crackhead said...
Relax, Don't get your panties in a wad because when the Supreme Court deems forcing Americans to buy HC unconstitutionalm, you will go back to your cave with your food stamps. Have a nice day
March 28, 2010 at 10:23 AM Report abuse
henryelm said...
30 million more customers CREATES more jobs and MORE Doctors!!! Maine was ahead of the curve. It is why UNE is ADDING a pharmacy school. And is preparing for new DOCTOR enrollments. And on Page A4 the headline is " DOCTORS expect to BENEFIT from the health care bill: With million more insured there will be less charity work, earlier diagnosis and (YUP) HIGHER PAY for some." well well well could it maybe CREATE JOBS!!!OH yeah and it SUBSIDIES DOCTOR education and has incentive for them to become and stay primary care Physicians INSTEAD of becoming specialist. expect seward to eat his words.
March 28, 2010 at 10:33 AM Report abuse
Blazen said...
The plan $940 billion for coverage of approximately 32 million averages about $30 million per person. Now that's what I call "Bang for you Buck"!
March 28, 2010 at 10:34 AM Report abuse
henryelm said...
cracked another healdline in the papar today: "GOP: Democrats co-opted original insurance mandate concept" ( from them) . translation: the GOP was FOR the mandate before they were agin the mandate. And NOW they are saying "GEE that was OUR idea and the D's stole it from us". Can you say flip, flop- flip, flop. I guess NOW they LIKE the idea (they are afraid the "contibutors" will Thank the D"s for all those new custiomers and "reward" the D's instead of them :"Hey we like the idea too...NOW!!HEY it was OUR idea first) YUP they are ABANDONING YOU and your argument about constitutionality. Can't wait to see how THIS plays out. FLIP FLOP, FLIP FLOP.Watch those constitutional lawsuit quickly disappear. photo op that is all.
March 28, 2010 at 10:50 AM Report abuse
henryelm said...
cracked another healdline in the papar today: "GOP: Democrats co-opted original insurance mandate concept" ( from them) . translation: the GOP was FOR the mandate before they were agin the mandate. And NOW they are saying "GEE that was OUR idea and the D's stole it from us". Can you say flip, flop- flip, flop. I guess NOW they LIKE the idea (they are afraid the "contibutors" will Thank the D"s for all those new custiomers and "reward" the D's instead of them :"Hey we like the idea too...NOW!!HEY it was OUR idea first) YUP they are ABANDONING YOU and your argument about constitutionality. Can't wait to see how THIS plays out. FLIP FLOP, FLIP FLOP.Watch those constitutional lawsuit quickly disappear. photo op that is all.
March 28, 2010 at 10:51 AM Report abuse
Relax said...
crackhead, I'm so sorry your glass and mind is so empty. I do encourage you to keep speaking here. The people need to know what kind of people represent the opposition to HC. You're one of the best. But you're wrong. Wrong sexual reference. Wrong about the supreme court, that's not going to happen. But you're free to keep hoping, wishing and dreaming. Wrong about my castle and income. Some folks just care about others. I know that's hard for someone like you to comprehend. All you have is hateful misguided ranting, what kind of an income and life does that provide for ya?
March 28, 2010 at 10:52 AM Report abuse
cablegirl said...
Higher premiums, fewer docs,more govt redtape, longer waits for care,Govt control over your care, so what if there are a few GOOD things in the bill 2700 pages chock full of expenditures that have NOTHING to do with reform? Repeal,reload, reform
March 28, 2010 at 11:05 AM Report abuse
henryelm said...
flip flop flip flop flip flop Speaking with two tongues. R's in congress. "We LOVE the mandate (NOW) and what it will do for the insurers, health care industry and OUR campaign chests( please fill OUR camaipgn chests, again PLEEZE.Pretty pleeze with a cherry on top) We LOVE the exteneded arm of government, NOW. Meanwhile R governors say the opposite and are left out to dry , all on their own. DUPED, left playing the patsy. OOOPS, they forget to tell them and their followers, "Never mind, the insurers told us to back off or no money for us." Your marching paper and talking points are in the mail. I can't wait to see BOEHNER "deal" with this turn of events."oops, never mind"
March 28, 2010 at 11:14 AM Report abuse
AXeL said...
Biddy says doctors will "still make above average income". I suppose plumbers do, too. And people with the "interest in serving humanity will enter the field". You know, like the old days when only rich families could afford to be doctors. Trisailor says we can prescreen ourselves through the wonderful advent of personal computers! Yes, a part of Obamacare, according to liberals, is to HEAL THYSELF! --- Meanwhile, in Searchlight, Nevada, we have rabid Harry Reid liberals swarming the Tea Party Express bus, throwing eggs, changing street signs and physically intimidating the people arriving to express their Constitutional rights. Don't look for it on the mainstream media. THE REVOLUTION WILL NOT BE TELEVISED.
March 28, 2010 at 11:17 AM Report abuse
common_cents said...
As a user of the local health care system and related to several providers; I was surprised to see the growing shortage of general practitioners highlighted. It seems to me that the health system is rapidly splitting into tiers of specialty practices, and G.P.'s who are either affiliated with E.R.'s or group practices and take on all comers. Their role is evolving into that of an almost intuitive diagnostician---my intern fancies himself as the "HOUSE" of Brunswick, balanced 'fact' based diagnosis with an intuitive feel for me as his patient. We argue about 'what's wrong' and while we frequently agree, he always wins. He is the kind of physician who enjoys being challenged by his patients and rises to the challenge. O.K. that's the entry point. Radiating out are specialties who coordinate their treatments with my internist. ...I wonder whether the caliber of people coming into regional medical schools will be up to the challenge of being a gifted, intelligent diagnostician?
March 28, 2010 at 11:18 AM Report abuse
common_cents said...
TRISAILER sez: " I had a run in with a stubborn sinis infection. I did everything that a doctor would have told me plus I got my own culture done at a lab $50)to determine the type of infection and thus choose the most effective antibiotic. I shouldn't have needed to go to the doctor to get the prescription for the antibiotic. Eliminate the need for doctors only to write prescriptions and you solve the doctor shortage overnight. ....identical problem and situation. Still have chronic sinusitis but we've hashed out the various options, including removal of polyps where the cultures live. I think the 'patient'..me and Trisailer, have the obligation to do as much background research as possible, and present that to the diagnostician for a decision on what to do. Patients cannot, and should not ceed control over their health care!
March 28, 2010 at 11:23 AM Report abuse
common_cents said...
30 million more customers CREATES more jobs and MORE Doctors!!! Maine was ahead of the curve. It is why UNE is ADDING a pharmacy school. And is preparing for new DOCTOR enrollments. DUH, MaineCare expanded health insurance coverage to 28,000 people. DID EMERGENCY ROOM VISITS GO DOWN? NO they didn't in fact they showed a dramatic increase--see Kaiser studies. DID THE HEALTH CARE SYSTEM INCREASE STAFFING? NO, over 500 people have been laid off in the past 18 months--see Maine Hospital Association tracking rpts. The facts are opposite your political ranting; and if the rest of the U.S. follows MAINECARE & DIRIGO, we'll see a major downgrading of our Health care system and loss of personnel....just the facts, please, no snarky reactions.
March 28, 2010 at 11:31 AM Report abuse
Biddy said...
Absolutely. Patients can save themselves and their doctors time and money by doing research and narrowing down their condition as much as possible. More extensive health education in our schools would be a big gain in teaching people about the resources available to them. Also every person with internet access can save a bundle by buying prescription drugs online or from Canada. A precaution to take is to find the drugs that are under patent still so one can eliminate generic counterfeits. The brand drugs are the same there as here. Additionally there are many support forums online for almost any condition and sometimes taking part in them brings up some good solutions. Information is invaluable.
March 28, 2010 at 12:20 PM Report abuse
U3RldmUw said...
I don't get how even more demand for doctors is going to entice more people into the field, unless the pay goes up even more. As it is, the demand for HC professionals already outstrips the supply. Most of the motivated medical students go into a specialty where they can get big $$$. For the most part, the general practitioners are the lower tier medical students.
March 28, 2010 at 12:30 PM Report abuse
pphreader said...
I would love to know just how many consertvative tea baggers receive state ot federal subsidies,such as medicaid,food stamps,general assistance,SSI,SSDI.From the television coverage,both Fox and others...there are a lot of lower to middle income white folks out there shooting off their mouths but living off the big government teat.Tea Party + xenophobic facists/racists/nazis.
March 28, 2010 at 1:11 PM Report abuse
pphreader said...
Nazis, fascists,KKK,haters = tea party ...Give them Librium or give them meth...maybe that will make them shut up.i see a whole lot of of white trash popping off .I'd wager that there are more than I few meth lab trailer owners in those mobs...And i sw the teeth to prove it
March 28, 2010 at 1:18 PM Report abuse
MSH said...
More drivel about the PPH being a "liberal" rag....Where's Mr. Connor been during the "debate"?
March 28, 2010 at 1:31 PM Report abuse
SacoSam said...
Relax, we already had a shortage of HC professionals and that didn't draw hordes of students to the field as you are suggesting. Demand was exceeding the supply and will continue to do so.
March 28, 2010 at 1:35 PM Report abuse
SacoSam said...
pphreader, your comments serve as a reminder that racist individuals exists on both sides of the issue.
March 28, 2010 at 1:44 PM Report abuse
pphreader said...
SacoSam, Hateful rhetoric is a nasty thing but I truly believe a majority of the Tea Party movement are hypocrites and are scared.A majority of them do not have an inkling of understanding of Boston Tea Party.Taxation without representation.Tell me,how many of them got off their duffs and were politically active in the last election? How is it that McCain and Palin lost? And once again,how many of them receive government handouts? Now there's a poll that no one has the guts to publish.
March 28, 2010 at 1:55 PM Report abuse
SacoSam said...
pphreader, I support the Tea Party movement and I communicate daily with folks who are like minded. For the most part the group that I affiliate with are clear on our goals - a smaller, more accountable federal government and support of core constitutional values. We despise folks like Palin and McCain (aka. the Tea Party Express) who are attempting to co-opt the grass roots movement and who are part of the entrenched two-party system that prevents any REAL reform in our government. McCain, Palin, Reid, Pelosi.....they are all part of the same party in my book. The Power Party.
March 28, 2010 at 2:35 PM Report abuse
Relax said...
SacoSam, Perhaps, but in the end everyone knows and always expects demand to drive supply. Economics 101. Why should the HC professions be any different? If in the future the supply is too short we'll find fixes. Certainly the flip side of this HC equation wasn't working out for the general public and no one was doing a darn thing to change it. Could that lack of positive action have had anything to do with the shortage? Quite probably. Now we can let the AMA (Who backed this bill) make any changes they like or need in order to make it work well for the greatest number of people possible. That’s a good thing. At the very least now more people will have excess to HC and we (At least the Democrats) appear to be moving forward in a proactive fashion. HC job openings everywhere. Lets get busy training, get out there and do some good, make someone well and earn a decent living. Agreed, pphreader needs to find nicer ways to make or get his/her point across.
March 28, 2010 at 2:40 PM Report abuse
Mainedog said...
To the IDIOT that thinks Dirigo is a success, WHAT HAVE YOU BEEN DRINKING!!!! Dirigo has caused rates to increase and provided less competition for insurance companies that are willing to do business in the state! Dirigo has been a catastrophic failure! Dirigo is one of the reason Maine has a hard time attracting good doctors, this is what awaits the rest of America under this abomination of a health care plan! And those of you that point to Canada, let me ask you why than do their citizens come to this country for treatment and pay out of pocket for it. Why because America provides the best healthcare in the world! All of this will change and we will be greeted with higher premium costs, higher drug prices and sub-level care with longer waits for appointments and procedures! All this brought to you by the democratic party! Time to vote Pingree and Michaud out of office!
March 28, 2010 at 3:07 PM Report abuse
MainelyJack said...
Here is another benefit of the monstrosity that Obama and the Dam Dems have visited on us. Many primary care doctors who had been accepting medicare patients are changing their practice. They are downsizing their patient load, some by as much as 2/3 and beoming "concierge" physicians. They will not take medicare patients as medicare pays so little now, it isn't worth their time to do so. They will accept patients with full medical coverage who will pay for the service they receive. They will work fewer hours, make more money and finally have a life again. What of the thousands of patients that are being cut loose? Tough. They can call Pingree and Michaud and thank them for the mess they helped create.
March 28, 2010 at 4:25 PM Report abuse
smarty said...
Well, where is Oak today? I see a nurse practitioner who has her own practice. She is extremely well qualified and knowledgeable, compationate, easily accessible (she even makes house calls!)and takes medicare. She also works in a drs office where I first met her. I saw her rather than the dr because she spent more time with me and, when I didn't have insurance, charged me less than the going rate. She does order tests for me but for very good reasons. I highly recommend her or any other NP with the same qualities.
March 28, 2010 at 4:55 PM Report abuse
dcl4500 said...
Man all this crap, yes crap about tort reform, ask the doctors in Missouri how tort reform worked out for them, check and see how much it lowered their malpractice premiums....nada, not at all, it did however produce record revenue increases for the insurance companies that offered the coverage in the state. Tort reform, conservative speak for handing insurance companies a big payout.
March 28, 2010 at 5:45 PM Report abuse
Relax said...
Edward R. Murrow asked Dr. Jonas Salk, "Who owns the patent on this vaccine"? Salk's response, "Well, the people, I would say. There is no patent. Could you patent the sun"? Dr. Salk never patented his vaccine but stood to make billions from doing so. He was also quoted as saying that he was only interested in getting as many people get vaccinated as possible. For those claiming that all innovation in research will end with our new HC system I say that there are more doctors out there like Dr. Salk who will continue to work to save lives without looking to make themselves into multimillion dollar kings and queens. To suggest that the only reason folks go into the medical practice is to make globs of cash is insulting to these individuals and to the human spirit.
March 28, 2010 at 6:32 PM Report abuse
common_cents said...
While I don't have a definitive research study to prove it; the low wages and restrictions on socialized health care providers enabled hundreds of thousands of Asians....Pakistan, Philipines, India, with health care backgrounds and training to migrate to Canada and the U.K. You found the same thing happening in State mental hospitals in the U.S. where low wages and a low bar were common. Both the UK and Canada ran their health care systems on the backs of greatly underpaid nurses...migrant laborers rarely challenge government policies. The nurses strike in Canada broke the Canadian piggy bank and forced the government to invest billions in health care.....
March 28, 2010 at 7:38 PM Report abuse
henryelm said...
Elsewhere in the PPH today this headline: " Doctor expect to BENEFIT from Health Care Bill: with million more insured,there will be less charity care,earlier diagnosis and better pay for some." go read it.
March 28, 2010 at 8:11 PM Report abuse
ACHILLES said...
Trisailer - break out a dictionary every once and a while. You are an embarrassment.
March 28, 2010 at 8:59 PM Report abuse
ACHILLES said...
Trisailer, Oldguy, Biddy, Henryelm, Brightone and the rest of the moronic lemmings who constantly make posts about how only the dems 'care' about people and the cons sit around counting their gold pieces while the hunger die outside their mansions. Pathetic and weak. Reality is that the dems do nothing but propagate the problems that afflict the poor. As if the throwing of billions and trillions of dollars at poverty has done a damn thing to alleviate any of our social ills. Ask the blacks if they are better off today than they were 30 years ago. Many I'm sure have their lemming hearts in the right place but are too stupid to look beyond what the slave masters of the democratic party preach to them. Ohhh...it makes me feel good inside so it must be the right thing to do. Idiots.
March 28, 2010 at 9:12 PM Report abuse
ACHILLES said...
“Perhaps I am over-pessimistic concerning state and other forms of communal enterprise, but I expect little good from them. Bureaucracy is the death of any achievement. " -- Albert Einstein (1934)
March 28, 2010 at 9:26 PM Report abuse
null said...
It's too bad med school was so expensive. I'd love to be a primary doctor but can't afford the schooling...I'd stay in maine too.
March 28, 2010 at 9:58 PM Report abuse
JazzBox said...
I'm sure the aging population has nothing to do with an increased need for health care providers, right? I mean, it must be BHO's fault that people are getting older.
March 29, 2010 at 8:17 AM Report abuse
trisailer said...
ACHILLES, I actually agree with you that throwing billions at poverty has not produced the desired result, but I think it is because we have only given it half measures. It just strings it along and likely makes it worse in the long run. If we were a dedicated to a solution as we are , say war and weapons, we would have solved it and would be selling our idea to china. Some of the answers are education and mentoring, things that you probably take for granted. We know what will work, but for some reason refuse to make the effort. We would rather build prisons to house them which is a purely republican approach. Two million in prison and we can't built new prisons fast enough. The repugs can only give tax breaks and start wars, please tell me how that benefits anyone.
March 29, 2010 at 8:42 AM Report abuse
trisailer said...
I think that one thing that would go a long way towards soving the doctor shortage is for doctors to admit that they know a lot less than they pretend. One doctor friend of mine told me that on his first day of med school the professor told the class "half of what you learn here will be wrong and we can't tell you which half" I had cancer and managed to get into Sloan in NYC and be seen by the best. He told me the same thing that so little is known and there is so much hubris. Many doctors think their gods. The other issue is shortages in particular fields like geiatrics. When doctors and hospitals have to report mistakes and outcomes things will change over night because people will be able to finally see just how poor the overall profession is.
March 29, 2010 at 8:54 AM Report abuse
Mrbix said...
Any of you Mr Magoo's notice the clevage shot of the doctor to be???..Just Saying!!
March 29, 2010 at 10:03 AM Report abuse
PaulPortland said...
One week after the House of Representatives passed the health care plan proposed by President Obama and congressional Democrats, 54% of the nation's likely voters still favor repealing the new law. The latest Rasmussen Reports national telephone survey shows that 42% oppose repeal. Only 17% of all voters believe the plan will achieve one of its primary goals and reduce the cost of health care. Most (55%) believe it will have the opposite affect and increase the cost of care. Forty-nine percent (49%) believe the new law will reduce the quality of care. Sixty percent (60%) believe it will increase the federal budget deficit. Those numbers are consistent with expectations before the bill was passed.
March 29, 2010 at 10:04 AM Report abuse
MagneticPole said...
Democrats are psycho.
March 29, 2010 at 10:58 AM Report abuse
Scommentname said...
Reporter J Richardson has apparently resurrected his job with the newspaper by switching from enviro-whacko-ism to political whacko-ism. Just keep pumping out the Obama propaganda as if it were news and pompously ignore anyone trying to use this feeble discussion board for saying anything to the contrary. My guess is, in about a month or two, the annoited one will get around to global warming legislation again. With only 8 months remaining for the Obamakinz to "rule" this becomes a certainty.
March 29, 2010 at 11:01 AM Report abuse
Scommentname said...
Reporter J Richardson has apparently resurrected his job with the newspaper by switching from enviro-whacko-ism to political whacko-ism. Just keep pumping out the Obama propaganda as if it were news and pompously ignore anyone trying to use this feeble discussion board for saying anything to the contrary. My guess is, in about a month or two, the annoited one will get around to global warming legislation again. With only 8 months remaining for the Obamakinz to "rule" this becomes a certainty.
March 29, 2010 at 11:01 AM Report abuse
Oak said...
If the bill doesn't say that increasing the number of patients while not increasing the number of physicians will cause shortages, then there will be no shortages! There are no unintended consequences unless they are spelled out in the bill! Federal law supersedes the laws of the states, the laws of nature, the laws of physics, the law of unintended consequences, and the law of supply and demand! If it isn't in the bill then it isn't going to happen1 /sarcasm
March 29, 2010 at 11:22 AM Report abuse
trisailer said...
You gotta love these tighty righty's, they get their news from the disinfotainers and real, objective facts are propoganda. PP can't stop quoting polls, like anyone besides him cares. The only poll that matters is the one that is going to be taken in November. There is no doubt in my mind that we got bush because progressives were asleep, that will not happen this time. This will be a contest of intelligence over fear and emotion and I happen to believe that intelligence will win.
March 29, 2010 at 11:23 AM Report abuse
Oak said...
trisailer - It was fear and emotion that fueled the passage of this bill. Intelligent people are able to see that there are unintended consequences to even the most well intentioned legislation. Those who deny the obvious unintended consequences are either stupid, engaging in intellectual dishonesty, or so full of fear and emotion that they simply refuse. Besides, you seem to confuse education with intelligence. You can educate a complete idiot into regurgitating information at will, but you can't teach them to process that information.
March 29, 2010 at 11:34 AM Report abuse
trisailer said...
Of course there will be short term adjustments, they may even be significant, but they are short term and the benefits will be long term just as SS and medicare have been long term improvements. In Austrailia the doctors all went on strike after single payer was passed and it took years to settledown, but everyone now agrees that it was a good thing for the country. With all the unemployment currently we should be offering healthcare to everyone. Death from curable ailments shouldn't be the price for being laied off from your job.
March 29, 2010 at 11:35 AM Report abuse
trisailer said...
Oak, you know that we agree on a lot of issues. Help me to understand how it is that most soldiers on the battlefield would risk their own lives to save a fellow soldier. He wouldn't stop to check his credentials or his upbringing, or his color, he would just try to help. Some of the citizens suffering at this moment are vets. The government has the power to send them into war to defend the country but should not require everyone to sacrifice equally? I never was on a battlefield, but I can certainly help my fellow American's now and I am happy and proud to do so. So I don't live in a big fancy house and drive a expensive car, maybe I could if I was selfish and greedy. If we all looked in our own community we could find a way to help. If we did that there would be nothing left for the government to do.
March 29, 2010 at 11:53 AM Report abuse
Oak said...
If we all looked in our own community we could find a way to help. If we did that there would be nothing left for the government to do. The first case is voluntary, the second is conscription. An unfortunate unintended consequence of putting more and more charity and good old helping out in the community to the federal government is that there is less of an incentive to do any of it voluntarily. It also removes the decision making process from those doing the helping and those who are to be helped, and puts it in the hands of bureaucrats and lawyers thousands of miles away who could care less about anything but advancing their careers. You can deny unintended consequences all you want, but it doesn't make them go away.
March 29, 2010 at 12:01 PM Report abuse
pphreader said...
Incentives to get medical students into Primary Care(family practice,internal medicine,pediatrics,and genotology)is necessary.That would mean loan /debt relief.MD's are completing their residencies with often more than 250K in loans and debt.Avg salary for primary careis 125 K /yr.Specialists make a lot more .Medicare,Medicaid and private insurance reimburse specialists for procedures.Most primary care providers are paid pennies on the dollar from the state and feds.Insurers capitate primary care at a fixed rate.All of this must change.The "market" is not the solution.That has been proven.
March 29, 2010 at 12:09 PM Report abuse
AR5 said...
PPReader, great points. Also, the new Tufts school was created to address this issue as well.
March 29, 2010 at 12:40 PM Report abuse
Oak said...
pphreader - No, what has been proven is that the regulated "market" is a failure. Government intervention is the failure. Hubris has failed. Regulations designed to fix problems created by previous regulations create more problems. We're at a point where the level of regulation has created so many problems that at the "market" can barely function. So the solution is go have it managed completely by government? This is an exercise in lunacy!
March 29, 2010 at 1:54 PM Report abuse
SacoSam said...
Oak, I couldn't agree more. The root of the problem is lack of competition in the insurance industry. Try buying insurance from a company outside of your state. THAT is why groups like Anthem can get away with raising their rates; They only have to compete with insurance companies in the state. As the rates have gone up, we've tried making health care more accessible to those that can't afford it (through Medicare) but that did not stop the costs from going up. The answer is less regulation (competition promotes lower rates, innovation) or a complete takeover of the HC system by government. Consumers or wards of the state. I choose consumer.
March 29, 2010 at 2:27 PM Report abuse
trisailer said...
You answered my question Oak. If the government didn't do it than it wouldn't get done and I would not want to live in a society like that. Your ideas were tried in many places at many different times and the result was always the same. suffering and ultimately all the money winds up in the hands of a few. The fact is that most regulations do produce the desired result and when they don't it is because the regulation needs to be improved not disposed of completly. You still have not answered the question of where is the unregulated utopia you expouse and give me an example of a benefit to society that was not the result of government intervention.
March 29, 2010 at 2:41 PM Report abuse
smallfarm1 said...
There is already a great federal program for tuition reimbursement for providers and it includes dentists. 2 yr commitment in an underserved area, of which there are several in ME. Called HRSA. And remember, this is not an 8-4 job. Most are on call for their office 24/7/365. It's not the glamor job most think it is.
March 29, 2010 at 2:50 PM Report abuse
Oak said...
Your ideas were tried in many places at many different times and the result was always the same. suffering and ultimately all the money winds up in the hands of a few. The idea that all problems can be solved through government has been tried many times in the past and the result is always the same. Totalitarianism. It comes in many flavors ranging from Socialism to Communism to Fascism, but they all have a few things in common. Power is concentrated in the hands of a few. Rights do not exist naturally and are protected by government (as described in that silly yellow document upon which our country was founded), rather government is the issuer of rights. You are not free to do what is not prohibited, rather you are free to do only what is allowed. Everyone serves The State. I don't want to live like that, but it appears I will have no choice.
March 29, 2010 at 2:57 PM Report abuse
trisailer said...
Again you rattle on without offering an alternitive or an example of your utopia. The happest societies on the planet are highly regulated and taxed, the difference is they are fairly regulated. They are not totalitarian in the least in fact the very people whom you support have move this society closer to a totalitarian society by deregulaing it. Deregulate it further and all the wealth will end up in the hands of a few quicker than is happening now.
March 29, 2010 at 4:08 PM Report abuse