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I Am a Primary-Care Provider oomsday is coming. There are going to be too many patients and not enough primary-care providers. It is in the paper or on TV every other day that the number of patients is increasing and the number of primary-care providers will be nowhere near the number needed.


They are right if they only count the physicians providing primary care and the nurse practitioners who function under a physician’s supervision. The number of patients is increasing for two very big reasons. First, we are getting older. I, and many people like me, have lived longer than we were supposed to. When you live longer, it is often due to better medical care. And that usually means more medical care. When you live longer, your illnesses are often more frequent and require more medical care to cure them. Second, more people are going to be able to get care as the Affordable Care Act is implemented. (Even if it gets gutted by next year’s Congress and administration, there will be more care.) The number of primary-care providers is decreasing. Family practice physicians are dying, retiring, or moving to other practice settings. New physicians take a look around and rapidly decide that if they are going to pay their education debts, they will have to specialize. Pedi40


George Pennebaker, Pharm.D.

atric and OB/GYN primary-care practitioners have the same problems, and are shrinking in numbers.

The Realities There are lots of folks who have analyzed all of the above and have come up with numbers that are impressive. Those numbers say that something has to give, something has to change. I believe that many things must change. Some of them are: ■ Primary-care physicians need to be paid more. ■ The number of nurse practitioners needs to increase. ■ The care delivery systems (all of them) need to be repaired and updated. ■ Patients, and potential patients, need better education and increased motivation to take care of themselves. One huge step that can happen rapidly and be very effective is to make changes that will allow and encourage pharmacists to practice what they have learned to do — primary care. Every day that I work in a pharmacy I spend some of my time providing primary care. I am a primary-care provider. I answer questions, give advice, refer patients, recommend therapies, and often tend to the patient’s emotional needs as well. I spend too much of my time doing things a halfway decent robot could do better — counting to 30, matching