The family doctor, an endangered species

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Lately I’ve seen many stories about different species that are threatened with extinction. Elephants are being killed by poachers, and buffalo are rarely seen unless you’re touring some remote area of North Dakota. To that ever-growing list you can add the family doctor.

In case you haven’t noticed, the doctor who was once minutes away when your child had a high fever is now at some local hospital, where he’s a member of the professional staff. Between government restrictions and skyrocketing insurance costs, one by one, doctors are either leaving their practices or seeking the shelter of large institutions.

Trapped in the cycle of cuts in patient reimbursement and the need to see multiple patients in one day, the family physician is slowly disappearing. All over this region we see a new form of medical care, in the form of the walk-in doctor’s office. There is no doubt that the doctors working there are competent, but the idea of bonding with a walk-in doctor is a fantasy.

By now, most of us have seen an enormous spike in health insurance costs. Some of that increase goes to providing care for more patients under the Affordable Care Act, but a good chunk of it goes to the insurance companies, which figure you’re trapped and can’t go elsewhere. Once upon a time, a policyholder paid a modest co-pay. Currently the out-of-pocket grows bigger with each new policy, and is out of reach to a lot of families with urgent medical needs.

Another example of the decline in hands-on medicine is when you’re a hospital patient. I had the misfortune of being one in the past few weeks, and it was an eye-opener. Your physician does visit you to discuss your case, and that promise is kept. But once upon a time you would see doctors in training. They were the team of people who would wake you up early in the morning to discuss your case and report to your doctor.

During my brief stay at a hospital that will remain unnamed, the only people I saw were a physician’s assistant, a nurse and a case manager. While they’re dedicated and concerned about your care, it is still more comforting to talk to someone who knows something more about your case history. Those bright-eyed doctors in training are also becoming extinct.

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