Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Rest in peace, primary care

Alexis Gopal, MD
Physician
January 18, 2021
Share
Tweet
Share

The corporatization of medicine has destroyed primary care as a specialty. The primary care physician is supposed to be your go-to doctor, your advocate, the coordinator of your health care. Now that corporations buy out hospitals and private practices in an almost predatory fashion, the priority is turning a profit for the corporation at the expense of not only patient health but also the health and well-being of the primary care physician. Who do you think bears the brunt of patient frustration and public misconception? The PCP.

Patients actually accuse salaried primary care physicians of being greedy, “that’s why you don’t spend enough time” during those seven-minute visits. The reality is that in corporatized medicine, the physicians don’t make the rules. More often than not, hospital administrators with no clinical background or experience dictate how these practices are run. They decide how many patients you need to see in a day to turn a profit, to maintain the salaries of superfluous middle managers.

Primary care has become an unsustainable specialty. The average internal medicine patient, especially the older demographic, has numerous chronic medical issues. How does a primary care physician address their concerns in such a short visit, much less develop a relationship, which is just as important to patient health?

At the beginning of my career, I took great joy in learning about each patient, their family and home dynamic, having two minutes to chat about “how’s the family?” Now, it’s a challenge to make eye contact, as the pressure to document on the electronic medical record to maximize reimbursement and prevent litigation is the priority.

The nail in the coffin? There are several. In one of the wealthiest nations in the world, why are our patients so chronically ill? Rates of obesity, autoimmune disorders, cancer, cardiovascular disease are increasing. Assembly line medicine has led to “band-aid” medicine, relying heavily on pharmaceuticals to put out fires, because who has the time to focus on prevention and lifestyle counseling?  Oh, and those greedy, millionaire PCPs, as the public perceives them? Their salaries actually go down every year, and they have to make up the difference by seeing more patients, in these poorly constructed RVU systems. Physician burnout is at a record high, understandably so. Primary care physicians are leaving medicine in droves. An already existing shortage will reach devastating levels in the very near future. Corporations like Walmart are opening clinics staffed mostly by nurse practitioners.

Who will care for the complicated patients, who may have rare illnesses in addition to the common fare like diabetes?

I fear for the future of health care in this country. Until the day physicians become as well organized and as strong a lobby as nurses, pharmaceutical companies, and health insurance companies, primary care is doomed as a specialty. Rest in peace, primary care.

Alexis Gopal is an internal medicine physician and can be reached at Vitality Medicine of New York. She can also be reached on Instagram, Facebook, YouTube, and Pinterest.

Image credit: Shutterstock.com 

Prev

Can we stop wasting the COVID-19 vaccine?

January 18, 2021 Kevin 1
…
Next

COVID vaccines, overcoming skepticism, and pandemic theater [PODCAST]

January 18, 2021 Kevin 0
…

Tagged as: Primary Care

Post navigation

< Previous Post
Can we stop wasting the COVID-19 vaccine?
Next Post >
COVID vaccines, overcoming skepticism, and pandemic theater [PODCAST]

ADVERTISEMENT

More by Alexis Gopal, MD

  • The body positivity movement: Has it become toxic?

    Alexis Gopal, MD

Related Posts

  • Primary Care First: CMS develops a value-based primary care program for independent practices

    Robert Colton, MD
  • How the CPT system shortchanges primary care

    Richard Young, MD
  • Primary care makes a difference for patients and the nation

    Glen R. Stream, MD
  • The many benefits of strengthening the primary care workforce

    Nicole Liner-Jigamian, MSW
  • Primary care faces a very difficult winter

    Ken Terry
  • The biggest health care fix: a relentless focus on primary care

    Suneel Dhand, MD

More in Physician

  • Why more doctors are choosing direct care over traditional health care

    Grace Torres-Hodges, DPM, MBA
  • How to handle chronically late patients in your medical practice

    Neil Baum, MD
  • How early meetings and after-hours events penalize physician-mothers

    Samira Jeimy, MD, PhD and Menaka Pai, MD
  • Why medicine must evolve to support modern physicians

    Ryan Nadelson, MD
  • Why listening to parents’ intuition can save lives in pediatric care

    Tokunbo Akande, MD, MPH
  • Finding balance and meaning in medical practice: a holistic approach to professional fulfillment

    Dr. Saad S. Alshohaib
  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Beyond burnout: Understanding the triangle of exhaustion [PODCAST]

      The Podcast by KevinMD | Podcast
    • Facing terminal cancer as a doctor and mother

      Kelly Curtin-Hallinan, DO | Conditions
    • Online eye exams spark legal battle over health care access

      Joshua Windham, JD and Daryl James | Policy
    • FDA delays could end vital treatment for rare disease patients

      G. van Londen, MD | Meds
    • Pharmacists are key to expanding Medicaid access to digital therapeutics

      Amanda Matter | Meds
    • Why ADHD in women requires a new approach [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 15 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Beyond burnout: Understanding the triangle of exhaustion [PODCAST]

      The Podcast by KevinMD | Podcast
    • Facing terminal cancer as a doctor and mother

      Kelly Curtin-Hallinan, DO | Conditions
    • Online eye exams spark legal battle over health care access

      Joshua Windham, JD and Daryl James | Policy
    • FDA delays could end vital treatment for rare disease patients

      G. van Londen, MD | Meds
    • Pharmacists are key to expanding Medicaid access to digital therapeutics

      Amanda Matter | Meds
    • Why ADHD in women requires a new approach [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Rest in peace, primary care
15 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...