Letter: primary care practice now brings little joy

The non-medical tasks physicians now have to perform have removed much of the enjoyment that comes with practicing medicine, a reader says.

Re your article, “Why primary care physicians are seeing fewer patients” (November 10, 2014): You were correct to point out that the numerous non-medical tasks that have insinuated themselves into the practice of medicine have made primary care doctors much less effective and at the same time have robbed many of them of the joy and satisfaction of practice.

This in not just a common complaint but a serious and growing problem that is changing the identity of primary care and how and who practices it.

Because primary care has devolved into a coordinative activity, many physicians no longer treat the severity of diseases that they had in the past. Many no longer treat hospital patients or nursing home patients. Many refer out patients to specialists that they may have treated in the past. And burnout is high among many primary care doctors.

Add to this that a primary care physician has existed for years and will exist into the future because it takes about 11 years to train a primary care doctor and it is clear that the primary care workforce of the future will look very little like it does today.

The training programs for primary care will be shortened by at least three or more years and made more practical. Advanced practice nurses will be playing an important role in providing primary care services. Already they have the right to practice independently in over 20 states.

Perhaps the severest and saddest comment that can be made about primary care in its current form is that I have yet to hear a colleague say that he has recommended that his son or daughter enter it as a profession.


Edward Volpintesta, MD

Bethel, Connecticut

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