Tag Archives: primary care

Panel of primary-care providers at Health Journalism 2013 #ahcj13

About Felice J. Freyer

Felice J. Freyer is AHCJ's vice president and chair of the organization's Right to Know Committee. She is a health care reporter for The Boston Globe.

A look at some of the issues, sessions and ideas to keep in mind for those planning to attend Health Journalism 2013, the annual conference of the Association of Health Care Journalists.

If you’re looking for a thrilling health care story, the local primary care practice is probably not the first place you turn. Primary care is tough to write about, tough to illustrate: the day-to-day interactions in the exam room pale before the cool stuff like robot-assisted surgery or brain-mapping.

Yet there are few more vital – or rapidly changing – sectors in health care. Want to better manage chronic illness? Prevent hospital re-admissions? Promote electronic health records? The primary care provider has got to be at the center of any such efforts.

And what will happen when millions of people who obtain insurance under Obamacare start to look for primary-care doctors, already in short supply?

For a better grasp of these issues – and an infusion of enthusiasm – come to “The Future of Primary Care: Who Will Take Care of You?” at Health Journalism 2013. The panel, at 4:40 p.m. on Saturday, March 17, will feature four primary-care providers working on innovations that may surprise you.

Learn how one practice became a 365-day-a-year operation, based on teamwork, driven by data. Hear about a practice where providers don’t try to cram in 30 patients a day, but take as much time as they need with each. Find out about a trainee-led movement in medical schools around the country to promote primary care, change the way it’s taught, and encourage more doctors into the primary care workforce. Hear about what new skills primary care providers are learning to function in a changing environment.

You can expect to walk away with an armload of story ideas, and a new appreciation of the potential role for primary care in redesigning the health care system as a whole.

Rural health care in Calif. nearing ‘crisis’

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

In a collaboration between the California HealthCare Foundation Center for Health Reporting and the San Francisco Chronicle, the center’s David Freed ventures into rural Mendocino County in northern California to explain and examine the ongoing (and worsening) shortage of physicians in American rural areas.mendocino-ca

Ukiah emergency room physician Marvin Trotter says that within the next five to seven years, the shortages will grow into a “full-blown health care crisis.” It’s a crisis about which the 58-year-old doctor speaks with eloquence and force.

“You’re going to see more complications and a lesser quality of life,” said Trotter, who puts in 12-hour days three days a week in the emergency room at Ukiah Valley Medical Center, the town’s only hospital. “You’re going to have your foot cut off more as a diabetic. You’re going to have more heart attacks because nobody’s taking care of your cholesterol. You’re going to have more people lose their vision because they can’t get in to see an ophthalmologist. That’s all a function of physician accessibility, and accessibility’s going away.”

Trotter’s quote is a reminder that, for rural America, “doctor shortage” means far more than just primary care. For a broad overview of the growing rural physician shortage, I recommend the “Older doctors, fewer hours” subheading on the story’s first page. The following subhead, “Scarcity at critical levels,” offers a deeper look.

In the second story in the package, Freed looks at how rural communities are working to solve the shortage, and why their efforts keep falling flat.


Program Draws Medical Students to Fresno: A program for third-year medical students is hoping to fight something long intractable: a shortage of doctors in rural and impoverished areas.

New website features center’s health reporting
Calif. organization names AHCJ members to staff
Calif. foundation backs new model; will be hiring
Nonprofit, paper team up for project on med school
Project launches test of a new model for health journalism

How will aging doctors affect your community?

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

AHCJ member Ryan Sabalow, a reporter at the Redding (Calif.) Record Searchlight, recently looked at the age of doctors in his county, finding that “nearly two thirds of Shasta County’s doctors are older than 50, and there aren’t nearly enough young doctors lining up to replace their retiring peers.”

Sabalow freely admits he’s not the first to cover the topic and acknowledges the work of Ventura County Star reporters over the summer. In a Reporting on Health blog post, Sabalow suggests that reporters contact the state medical board and request the an age range of physicians in their county.

The Association of American Medical Colleges forecast that the “passage of health care reform will increase the need for doctors and exacerbate a physician shortage driven by the rapid expansion of the number of Americans over age 65.” For a look at how many physicians are practicing in each state, as well as how many are in school, see the organization’s state-by-state statistics.

Some resources on workforce issues for AHCJ members:

Assessing acute care in America

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

The New York Times‘ Kevin Sack reports on a Health Affairs study that explores “acute medical care,” particularly initial visits for the fever and cough type of stuff that would traditionally go to a primary care physician. While 42 percent of such visits were still handled by a patient’s personal physician, a full 28 percent took place in emergency rooms. According to Sack, that number includes almost all visits made outside of typical office hours, as well as most visits made by patients without insurance.acute1

More than half of acute care visits made by patients without health insurance were to emergency rooms, which are required by federal law to screen any patient who arrives there and treat those deemed in serious jeopardy. Not only does that pose a heavy workload and financial burden on hospitals, but it means that basic care is being provided in a needlessly expensive setting, often after long waits and with little access to follow-up treatment.

Reform provisions such as medical homes, accountable care organizations and more money for primary care seek to rebalance acute care delivery in the United States, but Sack reports that the study’s authors fear it won’t be enough.

The authors warn that it might not be enough. “If history is any guide, things might not go as planned,” they wrote. “If primary care lags behind rising demand, patients will seek care elsewhere.”

Remember, free access to Health Affairs is one of many perks enjoyed by AHCJ members.

Why young docs shun practicing in rural America

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

For a look at the quotidian struggles facing young doctors who accepted federal loan aid in exchange for a three-to-five-year commitment to practicing in underserved rural areas, The Washington Post‘s Darryl Fears profiles a 33-year-old, Northwestern-trained doctor working as the only full-time physician at a practice in rural Virginia.


Photo by Bluegrass Annie via Flickr

Having learned her trade in a world of electronic medical records and iPhone diagnostic apps, the physician is at sea in a world of paper records, dial-up Internet and 40-mile drives to the full-size grocery store. There are few dating prospects, and even less culture. She’s not convinced that she’ll stay in town beyond her initial commitment.

Retaining these young, eager physicians is the next big challenge facing the stimulus-boosted National Health Service Corps, which placed thousands of doctors in rural areas last year, and is gearing up to do the same this year.


Rural Health Journalism Workshop: Speaker presentations

California’s doctors: Aging, white and specialized

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

In California Watch’s blog, Joanna Lin breaks down the California HealthCare Foundation’s latest report on the state’s physician supply. Nationwide, a quarter of physicians are over sixty. In California, which leads the nation in doctors nearing retirement, that number is 29 percent. In addition to aging, the state is also faced with particular ethnic disparities among caregivers.

… Latinos represent 37 percent of the state’s population, but 5 percent of its doctors. The disparity is even greater in the Central Coast, Inland Empire and San Joaquin Valley regions, and most severe in Los Angeles County, where 47 percent of the population and only 5 percent of doctors are Latino. Statewide, 18 percent of doctors speak Spanish.

While California led the nation in retention of graduating state medical students, a “substantial proportion” of California doctors come from other states and countries, Lin writes. That number may shrink as the UC system plans to add two more medical schools in the next five years, budget willing. For more specifics, take a look at the report itself. It’s loaded with easy-to-understand summary statistics and beautiful charts and graphs.