Good care flows from maintaining medicine as a desirable career

LETTER — Posted July 17, 2006

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Regarding "Primary care doctors in demand; signing bonuses and higher pay for some" (Article, June 19): As a case example, your article speaks to the benefits of low supply -- the physician "was able to negotiate a package tailored to the way he wanted to practice."

I have read with interest the many articles projecting a physician shortage and the subsequent belief that we need to increase the number of physicians. I must admit that I do not see that such steps would benefit our profession or ultimately our patients.

Historically, we have seen that markets dynamically correct themselves for supply and demand. In the near term, when a service is in short supply, the providers of that service enjoy better working conditions and compensation.

Others then decide to train and provide that service as well. Over time, supply and demand reach a dynamic equilibrium. (Keeping in mind that alternative and substitute supplies may exist, e.g., foreign-trained physicians, PAs, NPs, prescribing pharmacists, etc.)

In the same issue as an article on medical schools expanding enrollment to increase physician supply, the cover article was "Practice climate shows a decade of decline" (Article, May 15), citing an [index based] on "everything from managed care hassles to rising real estate costs."

If the marketplace set by legislators, regulators, insurers and/or consumer demands once again makes medicine a highly attractive profession, the best and the brightest will seek it out, entering an environment where forces allow physicians to provide patients with compassionate, high-quality, efficient medical care.

Gregory Hess, MD, Plymouth Meeting, Pa.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2006/07/17/edlt0717.htm.

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