published an article which featured powerful insight concerning the problems with primary care. One of the physicians sees direct primary care as a solution which is free from many of the burdens that cause primary care physician burnout:

Primary care is dying because burdens are too great

After 21 years in primary care, I say: Let it die. 

The burden is too great, the liability preposterous, and the reward a corrupted, bastardized pittance of what we are worth.  I think that if most “PCPs” knew what plumbers, insurance agents, builders, drug reps, and local government administrators made in salary, benefits, retirement, and paid holiday, they would quit and walk away.  And do not forget the dentists—rich, no liability, and less education.

Thank God today’s students have the internet to search the real value of each subspecialty. There is the reason medical students won’t go into primary care. They know now what my generation did not: We are worth very little money. Our years of training, our years of experience in practice, our dedication to our patients, our long hours of work, and artificially supposed liability—all our personal sacrifice is worth next to nothing in 2019.

I say it is not worth fighting for—let the nurse practitioners have it. For treating us physicians so poorly at the hands of the health insurance companies, the Medicare/Medicaid monopoly, the filthy plaintiff’s attorneys, the greedy hospitals, and the subspecialty board organizations (see RUC corruption), this country will soon have no quality, home-grown primary care physicians.
Then the United States will experience the old adage: “Be careful what you wish for—you just might get it.”

Erik S. Richardson, MD
Oxford, Miss.

Direct primary care can be revolutionary

Kudos to Rob Lamberts, MD, for explaining direct primary care [In his monthly columns on] This is truly a revolutionary movement removing insurance companies, government, and hospitals from the doctor-patient relationship. Not only will it lower costs and increase both doctor and patient satisfaction, but it will stimulate more idealistic medical students
to desire to enter primary care.

George B. Elvove, MD
Libertyville, Ill.

I believe the experience of these two physicians gets at a larger question: what other parts of the healthcare system would benefit from the removal of unnecessary government-imposed barriers? I talked about one in my research update this week.