Supply meeting demand isn’t always good. We watched for years as young doctors displayed less and less interest in primary care. They’re only human, after all. An income difference between primary care physicians and specialists that can be measured in hundreds of thousands of dollars is difficult to ignore.
That’s why the point made by Barbara Starfield, MD, subject of this month’s Q&A, serves as a warning. “The specialist, oversuspecting the likelihood of a serious illness, will do a very expensive and unnecessary workup. And all the things that are done in an unnecessary and expensive workup have a finite chance of an adverse side effect, including death… If you don’t have something that requires a specialist, it’s dangerous to see one.”
It’s difficult to see how the marketplace can fix this problem, since the marketplace seems to be the cause. Health plans will need to come up with some creative approaches.