Medical training programs should take notice of a new study that was published in Mayo Clinic Proceedings. It listed the top ten reasons why people see a doctor. Keep in mind these were people who lived in Rochester and Olmsted County, Minnesota, but I suspect the conditions are not too different across the United States. As I review the main reasons patients visit me, it seems like they got the list right. Here are the conditions that bring people to visit the doctor:
--Osteoarthritis and joint pain
--Upper respiratory conditions (not including asthma)
--Anxiety, depression and bipolar disorder
--Chronic neurologic problems
--High blood pressure
--Headaches and migraines
They found that most of these chronic, non-acute problems were not age- or gender-related. Half of the study population had a skin disorder like acne, cysts or dermatitis. Among children and teens the main problems were skin, joint problems and upper respiratory conditions. Patients over 65 showed up with high blood pressure, cholesterol problems and ... again skin disorders.
All of these problems should be handled in a primary care office. With the shortage of primary care doctors, however, we can expect health care expenditures to continue rising if these common problems are taken to specialists. In my community it is difficult to find dermatologists who will see "skin disorders" and most do not accept any insurance. They are happy to deal with cosmetic dermatology and biopsies but not routine dermatologic conditions.
Most orthopedic specialists are not interested in dealing with osteoarthritis, back pain or joint problems that do not require surgery or arthroscopy.
With less than 2% of medical students expressing an interest in primary care medicine it will be interesting to see where the bulk of patients will be getting their care in the future.
This post originally appeared at Everything Health. Toni Brayer, MD, FACP, is an ACP Internist editorial board member who blogs at EverythingHealth, designed to address the rapid changes in science, medicine, health and healing in the 21st Century.
Blog | Monday, February 18, 2013