Anyone who follows medical economics or medical blogs knows that primary care physicians are becoming few and far between. The number of young doctors who chose any specialty other than primary care (family medicine or general internal medicine) continues to rise. So it is no surprise that I just read an article about adding “Ancillary Services in Primary Care.”
It is kind of sad that taking care of the whole patient and serving as a well trained comprehensive doctor is at the bottom of the desirability food chain of medicine. Hospitals and multi-specialty medical groups see primary care physicians as “lost leaders.” We have become the “oil change” of medicine, so the big ticket “engine overhaul” can be captured by the high dollar procedures.
So now there is advice being offered for how primary care physicians should add new services to the “core” practice of patient care. Believe me, the “core” is challenging and time consuming enough but patients and payers don’t seem to see it that way. Here is what is recommended:
- Diagnostic tests on site such as Holter monitor, labs, imaging, treadmill testing. (Most of these require significant up front capital and the only way to justify it is to order lots and lots of tests … rising health care costs anyone?)
- Cosmetic procedures such as Botox, injectable fillers, laser hair removal, laser skin resurfacing, and vein treatments. (it worked for the dermatologists. Have you tried to find one to look at a mole or a rash lately?)
- Behavioral health like weight management, nutritional counseling, smoking-cessation. (Most of us do this for free. Hey maybe that’s part of the problem?)
- Alternative and holistic treatments like acupuncture, massage. (I see $$ for additional staff and space with little additional revenue.)
- Products like drugs, skin care products, and nutritional supplements. (Lots of doctors do this already. Does it put undue pressure on patients and represent a conflict of interest?)
I find it sad that primary care doctors are advised to get into these extra services in order to survive as a specialty. I certainly understand the economics. The average fee for laser hair removal is $503. It takes about forty-five minutes to do and it costs $1,100 for a two-day training course. It sure beats doing physical exams.
What do you readers think? Should your doctor get into these ancillary services?