It is called Cap & Trade. You cap admissions and trade the privilege of attending for insurmountable debt.

No, the shortage of primary care physicians has been caused by a system set up to reward subspecialists at the expense of primary care providers (family medicine practitioners, primary care internal medicine practitioners, etc.--and no, these are not the same as the old "GP" who was usually someone who did a one-year internship and no further residency and did not become board certified in a speciality, and both family medicine and internal medicine are specialities which require specialized postgraduate training).  Fee-for-service medicine, poor reimbursement, outrageous divides between what subspecialists make and what primary care providers make, even as we ask them to do more and more as gatekeepers and hubs of patient-centered medical home systems.  Think about the average amount of loans a medical student has to take out--now think about what the system says is valued by how easy or difficult it makes it for someone to pursue a certain speciality and get out of debt.

Jason - note, I was speaking of doctors in general, and not general practitioners.  You're correct regarding why more doctors move to specialties.

However, as it pertains to doctors in general, we have a shortage, hence why we're seeing a number of physicians from other countries practicing over here (and many are specialized).  For more than 2 decades, there were caps on admissions to med schools in the U.S.

www.usatoday.com/news/health/2008-02-26-doctor-sh ortage_N.htm

I got a good one for you BOTH...have going through a patient with cancer----1 primary...7 specialists.....tell me that I don't burn gas-time-phone calls...and that DOESN'T include the support services--not to mention BEER for the caregiver....

Ling - I actually know what you're talking about.. let's just say I've been down that road.. but it's not cancer.

GPs are nothing more than glorified physician assistants...

Ron, do you ever have anything positive to contribute?

So is our health care system working---not UNLESS they give authorization for the next specialist or appointment.....THEY say YES or NO---

And I haven't heard NO...and thats Government---TRI-CARE.....

If they don't give authorization, you always have the option to see that specialist on your own...

My parents have TriCare. It's quite the nice plan and affordable too now that my dad has reached mandatory retirement age. As for caps, all educational programs have caps on enrollment. Even my computer science graduate program had a cap. There are only so many students you can effectively teach with your school's resources. To teach more students requires more resources, which includes everything from more faculty to more physical space for classrooms and labs. It's not just something that can happen overnight, particularly in a lab-intensive program like medicine. Physical space is often a bottleneck and it takes time and money to get more space.

She earned hers from a ' fallen MARINE '.....

Shwaine - the caps were placed not because of a lack of resources, but because of faulty projections on the number of doctors needed in the coming years.

 LING:  And I haven't heard NO...and that's Government---TRI-CARE.....

and how long to get an appointment Ling?  My daughter has Tri-Care - I call it try-to-care - if she wants to see the SAME doctor each visit it is weeks before she can get in (she has a thyroid problem yet to be 'fixed'). If she sees whomever is available she can get right in but it is someone different every time (who decides, in their mind it is a different problem) who then has to re-approve for her to go to the specialist who will maybe see her in 6 weeks. You would think her husband's 22 years in the Marines (still in) his rank of Lt. Col, and his many trips (for a year each) to Iraq and Afghanistan would net them some special treatment eh? Nope. Take a number - get in line.

So, while you may have gotten lucky most go through the process as outlined above. In Canada (government run) my cousin had to wait 3 months just for an MRI to see if she has a cancer problem! Prior to that it was 3 months to see a doctor, and another 3 months to see the specialist.  She's 64 so I guess the government feels if she lasts the wait well ok, we will look into it. If she doesn't last the wait................................oh well........................next.

That's the reality of government run meds for ya.

While on the other hand right here in Bakersfield you can go to your very own doctor many times over a two week period.  Each time complaining of loss of appetite, pain, and explosive bowel issues.  No ultra sound, no MRI just pain meds prescribed.  After 3 trips to the ER someone finally sends you for an MRI then right back to the ER when MRI indicates a  blockage and  a supposedly urgent status where instead they just want to change your pain meds which BTW you cannot keep down.  Getting some area doctors to recognize a legitimate urgent situation if frustrating beyond belief.   Finally at the ER after not being able to eat for a week and throwing every liquid you do swallow right back up someone actually pays attention to you.   Guess what the problem was?   A cantaloupe sized tumor which required an emergency surgery.  This happened to one of my Bunco friends she is 79 years old.   Doctors need to listen to their patients.   Doctors need to stop throwing pain meds at the problems they see and actually investigate  and treat the cause of the pain.  The patient is resting at home and expects to be back at Bunco next month.  Thank goodness someone finally ordered x-rays.  Shame on all the doctors she saw who just wanted to send her back home with pain medicine.  

1 Week....daughter went through med school via dependents benefits at Stanford--works as a Reconstructive surgeon at Kaiser-L.A.----

So the goodies are there....

We haven't had no problem with them....can you imagine having NO HEALTH INSURANCE---then what---DIE?

Pretty much ling. A friend of mine was 32 when he kept going to the ER for loss of appetite, fatigue, passing out. Given pain pills 3 different times. The 4th visit triage told him, they weren't going to give him anymore pills.  My best friend who was his fiance, threw 2 bottles at the lady's desk and said he don't want pain pills.  Something is wrong with him. They waited and waited until just walking out.

Two days later, he collapsed (passed out, later said he fell into a come) when getting his 2 yr old out of bed.  Ambulance got him and took him to a different hospital and the ambulance worker asked if he had been treated for valley fever.  My best friend said no and explained everything.  He said the sore on his nose was a clue.  Well, he never came out of the hospital.  He was diagnosed with spinal meningitis due to disseminated valley fever.  Would his care had been different if he had insurance?  OR if he had a primary Dr he could afford to see?  I don't know the answer but I'm sure his son, now 9 will like to know some day.

So do we keep business as usual...or fix the damn system--how much is enough--

Tired of going broke for getting sick---or are you tired of making someone else RICH for your misery....

It's a no brainer....you can start with the POLITICANS that the medical industry BOUGHT to keep you POOR AND SICK....

IF it was up to me...I would say--- " The Marines are looking for a FEW good sharpshooters "....this is how you "Clean Beans"....

Have any of you guys seen the data detailing just how much money the drug companies spend each year for marketing,  doctors junkets, and lobbyists?   http://articles.mercola.com...     http://projects.publicinteg...    http://www.usatoday.com/mon...     Maybe they should fore go the use of lobbyists and pass the cost savings on to their customers.  (fat chance)    Pfizer to pay record $2.3 billion penalty

 Ronmexico---- Just what do you know about the work it takes to qualify as a  Master of Physician Assistant Studies?   PAs are not simply glorified Medical assistants.  After earning a bachelor's degree they return to school and earn their Masters.  My niece is doing that right now in Boston.   http://www.mcphs.edu/academ...

Michele----That is the same form of Valley Fever that I had from 1993 to 1997.  I was in the hospital for more than 250 days over a 3 and a half year period.   My hospital bill was over $250,000.  My HMO paid the entire cost without charging me a co-pay.  I think they do things differently now a days.

You think we have a doctor shortage now, a recent poll found that 45% of doctors would consider quitting if Congress passes a health care overhaul. 

Add to that the reality of some 40 odd million new health care customers being added to the system (with the promise that it won't cost any more and the care will even improve!) and  national health care will be positively Orwellian.

dril - the following poll disputes that claim:

www.npr.org/templates/story/story.php