LA TIMES: ‘A 20-year relationship with a doctor ends with the doctor’s retirement.’
By Sandy Banks Los Angeles Times
JANUARY 16, 2015 – I’ve been lucky for the last 20 years. I could listen silently while friends complained about their medical care. My doctor was never too busy or too brusque. He always made time to listen. I never had to pay concierge fees for what I knew was uncommonly good and thorough care.
But my luck ran out last summer when my doctor unexpectedly retired — pushed by some of the forces that are supposed to make patient care better and more accessible for the masses.
He was working harder, earning less, frustrated by bureaucratic demands and feeling the weight of his own advancing age. The day he hesitated when writing a prescription because he couldn’t recall the name of a familiar drug, he began thinking it might be time to move on.
His lapse lasted just seconds and probably wouldn’t have troubled his patients. I’d have drawn comfort from the fact that, at 65, he’s experiencing the same senior moments that I fret about.
Now my daughters are trying to console me. Maybe it’s time, they say, to find a young doctor, one who’s up on the latest research and armed with high-tech tools.
I prefer the experience of someone who doesn’t have to consult an iPhone app to figure out what my symptoms mean. A doctor who will return my panicked phone call and assure me that my middle-of-the-night vertigo is probably fleeting and benign and the black spots fluttering through my field of vision don’t mean that I’m going blind.
I intended to grow old with my health in the capable hands of a man I’d learned to trust. Instead I’m joining hordes of patients in California stranded by healthcare shake-ups and a looming doctor shortage.
The pool of internists and family practice physicians — the doctors we see for physicals and ordinary ailments — is shrinking faster than it can be replenished. Only about 20% of medical students in this country go into primary care. Most gravitate instead toward specialties that demand less and pay more.
Primary care doctors are supposed to be the linchpins of the Affordable Care system: They’ll track our health, head off problems, school us on prevention and coordinate whatever specialist care we need. But a recent study of healthcare in California found that only 16 of the state’s 58 counties had enough primary care physicians to meet residents’ medical needs.
Those doctors are bearing the brunt of the system’s growing pains. Their expenses are multiplying, their revenue shrinking and they feel burdened by government mandates and insurance company demands.
They’re the pioneers in our national shift from paper patient files to electronic medical records — a skills challenge in a field where almost 30% of the physicians are nearing retirement age.
Many complain that cumbersome record-keeping cuts into time they used to spend talking with patients. It can take hours each week to transcribe notes, check the right boxes and click through online drop-down menus for the proper codes for every treatment and diagnosis.
That too influenced my doctor to hang up his stethoscope. He chose internal medicine because he wanted to build relationships with patients; to look at us and listen, not tap away on a keyboard while we talked.