A Cri de Coeur from a General Practitioner
Robert M. Webster, MD
Is the general practitioner being cast in the role of a medical reject or is there a holocaust of general practitioners?
"You cannot be on our hospital staff because you are not a board certified specialist," said the hospital. A holocaust maneuver by the hospital?
"You cannot be one of our physicians," said the HMO, "You do not have a specialty board we recognize." A holocaust maneuver by the HMO?
"You cannot be a staff physician or Medical Director in our long term care facility (nursing home) because you do not have boards that we recognize." A holocaust of the general practitioner by the nursing home?
"But I am board certified by the American Board of General Medicine!"
"We and the American Board of Medical Specialties do not recognize that board," they say. A holocaust maneuver?
"I am a generalist --- a general practice physician! I have been to an accredited medical school and graduated with an MD or DO. I have had a year's internship. I have a license to practice medicine in this state," you reply.
"You must have boards in the specialty you plan to practice in this facility. Although you have pathology boards you cannot be on our medical staff as a general practitioner." A holocaust maneuver?
"No matter, we do not want you. You have no hospital appointment. Your board in not recognized." A holocaust maneuver by the HMOs and hospitals?
I look in the classified ads of the Journal of the American Medical Association (JAMA) and The New England Journal of Medicine (NEJM), the well-recognized "gold standard" of American medical journals sponsored by the Massachusetts Medical Society. The indices list "general practice" but I find a rare ad under the "General Practice" section if the section is there. However there are many ads for Family Practice, Primary Care, Pediatrics or Internal Medicine with subheadings to see also the sections of those other specialties. A holocaust maneuver by the editors, subscribers and the readers?
The insurance companies and other third parties pay (they say "reimburse") the physician according to his specialty's preference rate. The general practitioner is the lowest pay because (s)he is assumed to be a low quality physician. A holocaust maneuver by the insurance companies?
The students in medical schools are being taught by specialists. Some of the schools have Family Practice departments but no general practice professors. A holocaust maneuver by the medical schools? You be the judge!
Dr. Webster is a long term care consultant in Jasper, Georgia.
Originally published in the Medical Sentinel 2002;7(3):94. Copyright©2002 Association of American Physicians and Surgeons (AAPS)