All across the country, and certainly here in Northern Arizona, there are fewer family doctors than ever before. “I really like what I do and I feel privileged to serve in this community,” said Brad Frank, M.D., a Flagstaff family practitioner. He sees patients of all ages and prides himself on spending an appropriate time with his patients, ensuring he is answering their questions and addressing their needs. But he’s one of only a small number of primary care physicians (doctors who do not specialize in a specific area of medicine) in Northern Arizona.
Part of the problem is fewer medical students are going into family practice. A typical medical student graduate leaves school with upwards of $150,000 in student loans. According to www.salary.com, while many doctors in specialty fields (like pediatric surgeons and anesthesiologists) can earn more than $350,000 a year, family physicians usually bring home far less money – earning on average $173,000; however, that average includes many of the family practitioners that work for hospitals, or large multi-specialty groups. In small family practices like Dr. Frank’s, the income can be significantly less.
And the hours are usually long, with primary care physicians (PCP) spending nearly as many hours doing paperwork as they do seeing patients. To help handle that burden, Frank and his wife, Paula Baglioni, M.D., have hired an additional family doctor, and a nurse practitioner to help keep the practice viable. “Family practice is where we need to be. It offers variety and intellectually stimulating work. As primary care physicians we can handle most of the medical problems that come into the door,” he said.
“I’m seeing more patients, and worrying more about the business end of things. I’d love to have unlimited time with patients, but it’s getting increasingly difficult to do that. I really want to provide good compassionate care,” Frank added. But, add in the greater expense for staff, supplies and equipment, and many physicians are pushed into a corner. This trend is often bad for patients who get saddled with higher insurance premiums and co-pays from specialists, and less time from their PCP and specialist combined.
Kelli Ward, M.D., an osteopathic physician with offices in western Arizona, said she’s concerned about the limited number of PCPs. “Medical students who tend to choose their specialty by finding something they love to do are finding it more difficult to find a positive role model, because primary care doctors feel overwhelmed by the pressures and expectations. They also feel under-appreciated from a financial standpoint,” she said.
Eric Henley, chief medical officer at North Country Community Health Center (NCCHC), said he has been watching this trend for the past ten years and it is not getting much better. He says the reduction in the number of family doctors often means patients in rural areas lack adequate care.
“Patients should start with a PCP, and if the patient’s condition is more serious, they can get a referral to see a specialist. It’s often best for patients to start with their primary care physician because they work with people with prevention, overall health and mental and behavioral problems. Many people see a specialist when they don’t need it,” Henley said.
NCCHC is working to help the system. Every year, several medical students considering family practice and other medical fields are getting training at their facility on 4th Street. “About four of our current 10 students are considering family practice, and some aren’t sure what area of medicine they want to do,” Henley added.
Gillian Wackowski is one of the students, but she is certain she wants to be a PCP. “Being a family doctor isn’t as glamorous as being a surgeon, for example, and there are fewer television shows about family practitioners, but I really want to be an advocate for my patients. I want to see them from infancy and if possible, to help them face end-of-life issues,” Wackowski said. She estimates she’ll graduate from school in 2017. She will work for four years for the Navy and in return, it will pay all of her medical school costs.
Chad Taylor is also considering family medicine and is getting training at NCCHC. “I want to make a difference in people’s lives. I developed a passion for patient care when I worked as a medical assistant in Minnesota. I truly fell in love with the work,” Taylor said. He hopes more students follow the same path but admits the more lucrative jobs attract a far greater number of graduates.
In the meantime, Frank said, “We treat kids, to grandparents and have many four generation families. We’ve invested a lot of years in taking care of our patients and we want to maintain those personal relationships.” FBN
Drs. Brad Frank and Paula Baglioni can be reached at: 928-774-3627
North Country Community Health Center can be reached at: 928-213-6100