Doctors are in Demand | The Spectrum

Doctors are in Demand | The Spectrum

By: Cathy Wentz, www.the

CEDAR CITY - Although Utah ranked seventh in the nation in 2010 for health care, according to the United Health Foundation, the state still faces challenges in keeping residents healthy.

One challenge Utah needs to deal with is the low number of primary care physicians: 87 for every 100,000 people.

In a health environment that could change drastically in the next few years because of the recently passed national health care reform, primary care is the front line of medicine.

David Blodgett, M.D., director of the Southwest Utah Public Health Department, said when people have a primary care physician to coordinate their care throughout all its stages, health outcomes are better. Primary care physicians function as a patient's advocate to ensure that person makes it through the health care system.

Jason Wilson, administrator for Valley View Medical Center, said the facility has been fortunate in its ability to be satisfactorily staffed with primary care physicians in the fields of family practice, internal medicine, pediatrics and emergency medicine.

He said one of the problems causing a shortage of primary care physicians that he is aware of is the limited training opportunity for medical students to go into primary care. He said there has been discussion about needing to provide more residency opportunities for primary care physicians.

He said the other factor causing the shortage is economic. Medical school graduates are more financially rewarded for going into surgical specialties or ones in which they can perform a lot of procedures.

"So typically, the primary care specialties haven't made as much in our current system financially as some of your specialists have in the surgical area," Wilson said.

He also said there are provisions in the health care bill to target primary care and encourage people to go into primary care specialties, but the details are not known yet.

Tom Marshall, M.D., who works at the Intermountain Healthcare Family Practice Clinic, said malpractice is less of an issue for primary care physicians because the field is not as high-risk as those aligned with surgery and obstetrics. He said he used to deliver babies, but does not do it anymore.

Clint Bunker, D.O., also works at the clinic. He views his role of primary care physician as handling everything that normally happens.

"Most people will come to a primary care physician with their complaint," Bunker said.

His role is to determine whether the problem requires treatment beyond what he can do and where the patient needs to go. Although primary care physicians often act as gatekeepers to more specialized medicine, he said, they are not trying to keep patients away from those specialties, but rather act as intermediaries.

Bunker said when he went into medical school, his initial desire was to practice primary care because being able to take care of a wide range of patients and be well-versed in a lot of things was very appealing to him even though the specialties are more financially rewarding.

"It meets my needs, and I enjoy that so much more than I would being specialized," Bunker said

He finds that the most rewarding thing primary care is his interaction with a wide variety of patients, from a newborn to someone in their 90s, in the same day. He believes doctors going into primary care take that route because they want to have personal relationships with their patients.

"Specialists are very important; they're very needed, they're appreciated, but being able to see the general picture in taking care of those patients is very rewarding" Bunker said.

Wilson said the medical center has had some struggles in recruiting physicians for primary care specialties such as cardiology and it took more than a year of effort to recruit a cardiologist. They finally recruited Aarush Manchanda, M.D., for cardiology. However, they are still searching for a primary care neurologist.

Wilson said the hospital separates primary care and surgical specialties. The primary care specialties use medical intervention as opposed to surgical intervention.


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