Precarious future for primary care

SPRINGFIELD — Dr. Katie Jobbins rested her forehead in her hand, tapping her fingers rapidly as she waited for a crisis counselor on the other end of the phone to pick up. It was a busy spring day at the clinic on High Street, and one of Jobbins’s regular patients needed help.

“I have a patient . . . who is actively suicidal and homicidal, who I’m going to send to the ER,” she said urgently into the phone. As nurses buzzed around, Jobbins searched for the right admission forms.

Jobbins was frustrated. For a year, she’d been treating this patient for depression and thought they had made progress. Still, she was relieved the patient knew to seek her help.

At 30, Jobbins is new to front-line medicine, and is still deciding whether to stick it out. She was among nine junior doctors at Baystate Medical Center training in primary care at a time when young doctors are more drawn to lucrative specialties than life as a family doctor. The Association of American Medical Colleges predicts a shortage of 45,000 primary care doctors by 2020.

The consequences hit everyone. As veteran doctors leave primary care faster than they can be replaced, waiting times for appointments stretch longer, and coordination of care becomes more haphazard.