Increasing the number of doctors would make our health care system worse, not better, because the United States doesn’t actually need more doctors. What we do need is for primary care to reclaim its central role in the delivery of medicine, to provide the preventive care, chronic disease management and coordination of services that is lacking in so many parts of the country. Primary care doctors can help patients avoid unnecessary visits to specialists, hospitals and emergency rooms, thus lowering health care costs.
Granted, the teaching hospitals and others lobbying for more doctors would have Congress designate some of the new residency slots for family practice, pediatrics and internal medicine. But there are already plenty of residency openings in those areas that currently go unfilled. And since the amendment would not prohibit the positions going to specialists, that is who would fill them. If the past is prologue, these newly minted specialists would most likely gravitate toward cities like New York, Los Angeles and Miami, which already have plenty of doctors — and relatively poor care.
Our national problem is that primary care doctors are leaving their practices in droves, driven out by their low pay (relative to that of specialists), long hours and mountains of paperwork. Some of them go to work in emergency rooms or hospitals, others become specialists, and many simply abandon medicine. The idea that there’s a supply-side solution to this problem is a little like thinking you can fill a bucket with holes in the bottom by pouring in more water.
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