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The Fate of Medicine Today

January 26, 2015

It is becoming harder and harder to find a primary care physician to care for you. These physicians have been called general practitioners, family practitioners, and medical practitioners.  All of these specialists are generalists. They care for the whole patient. In spite of taking responsibility for the care of the whole patient, they are among the lowest paid of all specialties in medicine. Why is this?

 

For as long as I can remember there have been disagreements among physicians resulting in “turf” wars. It is easy to see why this occurs but difficult to understand. Each specialty wants to set boundaries that physicians not in their specialty should follow. Does that mean the cardiologist knows more than the emergency department physician on reading electrocardiograms? This all gets down to the skills of the various physicians. More often than not the ED MD is treating a patient in the emergency department in real time. They depend upon their skill in interpreting that patient's EKG and treating the patient accordingly. The money scuffle may often ensue when the cardiologist comes in the following morning, reads the EKG again and then expects to be the one paid for interpretation. Usually the patient has already been treated for their heart attack or whatever and are already tucked safely into bed in an intensive care unit. You determine who is most important in the reading of that EKG. You decide. The same money scuffle happens again with the emergency physician and the radiologist. My gosh, if a child comes in with a bent arm that is supposed to be straight and the ED MD says it is broken and needs to be put straight again, do we really need the radiologist to put in additional charges just because they are so specialized in knowing which bones are naturally straight and which ones are bent. Believe it or not patients out there this is not much of a simplification.

 

Because of minor examples of fighting within the medical profession such as above, I am using the emergency department physician above as an example of a primary care physician who is often overruled by the specialist who has more pull in the hospital hierarchy. Don’t jump on me my ED friends. I have fought on your side and that of family practitioners for many years.

 

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