A recent New York Times Opinion article addressed a potential problem in the US – are there enough infectious disease doctors? This is an issue that is growing, and that could have very dangerous consequences in coming years if not corrected.
Why are there fewer Infectious disease doctors?
Despite years of intensive training, infectious disease specialists are at the bottom of the pay scale for physicians, sometimes coming out even below the general practitioner, who has less intensive training. This is despite the extra training that the infectious disease specialists receive and the expert knowledge that they have. They often have to be called in for consultations and to conduct specified tests when the regular GP can’t make a diagnosis. The reason for the pay difference is that infectious disease specialists don’t actually perform many procedures, and procedures are what doctors can charge for.
After putting years and effort, not to mention hefty tuition, into obtaining a medical degree, most doctors choose a specialty that will have made it worthwhile. However, there are always people who either find the subject fascinating or want to go into it because they truly believe that they can make a difference in people’s health by specializing in infectious disease.
It’s also one of only two specialties that don’t always match for residency programs. Some students may end up choosing it only because they didn’t get their top choices and spots remain open for it.
How this may affect our health
With fewer men (or women) on the ground with specialized knowledge in infectious disease, that puts the population at risk when clinical care in needed. Sometimes an ID specialist is called in to consult on a case, and he may put in many hours trying to make a diagnosis, but not getting paid appropriately. Their work is cognitive, not procedural, and therefore does not have a lucrative reimbursement schedule. If there aren’t sufficient ID specialists to call in, proper diagnoses may not be made.
This is particularly worrisome, as new superbugs are being identified today, and most doctors don’t know what to do with them. As Dr. Matt McCarthy discusses in the NY Times article, he gets patients referred from internists and pediatricians who can’t figure out a case and he makes a diagnosis after careful testing and consultation. There are powerful new drugs on the market that can treat strong diseases, but most internists don’t know what they are or how to use them.
What can be done to change the trend
Right now, there’s a two-pronged approach to addressing the problem. One is that the Infectious Disease Society of America is spearheading initiatives to create more interest in the field. The second is that they are working with payers to increase the payments made for cognitive medicine to match or come close to that of procedural medicine, so those who are really interested in the field will be able to specialize and feel the need to turn to a more lucrative specialty.
At Sinai Post Acute Care Rehabilitation Center, we take care of all our infectious disease patients will warmth and dignity. Speak to one of our Representatives today.