Guest Post from Robert E. Harbaugh, MD, FAANS, FACS, FAHA
Director, Institute of the Neurosciences
Distinguished Professor& Chair, Department of Neurosurgery
Professor, Department of Engineering Science & Mechanics
The Pennsylvania State University
Milton S. Hershey Medical Center
Since posting a previous blog entitled, “The Primary Care Shibboleth: Debunking the Myth,” I have received a good deal of correspondence criticizing me for attacking primary care medicine and primary care physicians. If my blog was interpreted as such an attack I am sorry. That was not my intent. I did (and do) want to criticize Bruce Vladeck’s assertion that the key to fixing the problems in U.S. healthcare is to take compensation from specialty medicine physicians to give to primary care physicians. I don’t think it is surprising that most specialists are skeptical about the value of this proposal.
In my blog post I questioned the notion that preventive care will save a lot of money, that a shortage of physicians exists only in primary care, that the U.S. healthcare system is anomalous in regard to the relative number and compensation of primary care and specialist physicians and that it is a common practice for surgeons to recommend surgery solely for reimbursement. Finally, I make a vigorous defense of the value of specialty care. These points are not derogatory to primary care physicians.
To make my position clear, I believe that all physicians bring considerable value to our patients and would not make derogatory statements about any field of medicine. As a surgical specialist, I know what it is like to be caricatured as greedy and uncaring. Even President Obama has made statements suggesting that surgeons remove patients’ tonsils and amputate their limbs solely for the money. It is not only primary care physicians who are altruistic. In my experience both primary care and specialty physicians are deeply concerned about their patients, want what is best for them and play vital roles in their care.
Rather than succumbing to the divide and conquer tactics of policymakers and other thought leaders, physicians should come together to ensure that the healthcare system fully supports all of medicine so we have an adequate workforce to care for our nation’s patients.