Doctors discuss defensive medicine and primary care pay

Doctors at a North Carolina meeting called for tort reform to curb defensive medicine, while physicians in Colorado say the state's physician shortage is caused by low pay that discourages new doctors from turning to primary care.

The Wilmington, N.C., Star News reports on a community meeting at a dermatologist's office at which local doctors and politicians talked about defensive medicine, malpractice suits and tort reform. One participant suggested "a Fair Health plan in which health insurance companies would compete for government contracts to cover the uninsured. The costs would be through a sales tax on people without insurance." Another person suggested "tort reform and changes to the Food and Drug Administration are needed to drive down medical and drug costs." The Star News notes: "Several doctors who attended said they worry some changes aren't part of current proposals" (Reynolds, 9/17).

The Denver Post reports on Colorado's primary care shortage: "The shortage of family doctors isn't just a rural problem. Even in Colorado's larger cities, including Denver and Grand Junction, people can struggle to find a primary-care physician — particularly one that accepts Medicare or Medicaid. Nationwide, the number of new American doctors choosing primary care has dropped to 25 percent from 34 percent in 2001, according to the Association of American Medical Colleges. The plunge is likely to dip even lower, though, because many doctors end up sub-specializing during their residencies."

"At the University of Colorado School of Medicine, about half of graduates choose primary care, though only a fraction of those eventually become family doctors. The major reason for the shortage, doctors say, is low pay relative to specialties such as surgery or oncology or neurology. The average pay for a family doctor in the Denver area in 2008 was $157,430, while the average in Fort Collins was $106,180, according to the Colorado Health Institute. Compare that with a medical school graduate's average debt in 2008: $155,000. At CU's medical school, the class of 2008, with 124 students, had a cumulative debt of more than $17.1 million. The average per-person debt was $138,352 for medical school, plus $26,000 for undergraduate education" (Brown, 9/18).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.