Too Many Specialists; Not Enough Primary Care Doctors

Ezra Klein:

…The more doctors in your area, the more care you’re going to receive. And you generally won’t be any better off for it. You’ll just be poorer.

Added together, that’s a bit strange: It’s like saying we have too few people selling a product that we have too much of. But broken down a bit, it’s not that strange at all. We have too many specialists and not enough primary care physicians. Specialists are expensive and tend to recommend expensive treatments. As the Dartmouth Atlas Project has found, “more specialists per capita in an area is associated with higher surgery rates and higher procedure rates.” It is not, however, associated with better outcomes.

This gets to a point I’m going to make at greater length in the near future, but one quiet element to watch in health reform is that this country can afford universal primary care-based health care. It cannot afford universal specialist-based heath care. But specialist-based health care has a stronger set of political lobbies and is far more attractive to doctors.

Ezra has it right. I’ll be looking forward to when he discusses this at greater length.

Be Sociable, Share!

Leave a comment