To the editor,

One of the nagging problems in the healthcare world is that people who are studying to be doctors must choose between being a primary care doctor, otherwise known as a family doctor, or specializing so they earn more money. Many people choose to specialize which means that we have a shortage of primary care doctors.

Primary care doctors are the first ones we go to when we feel bad or need an annual physical. If the primary care doctor discovers that something is wrong with the patient, there might be a referral to a specialist. There are lots of specialists but very few primary care doctors and the shortage is getting worse as older doctors retire.

The federal government tried to solve this problem by altering the current system so that primary care doctors would be paid more and thus encourage more people to be primary care doctors. They did this by having the Centers for Medicare and Medicaid Services (CMS) increase the number of "care units" the family doctor gets for treating patients and increasing the amount of money for each care unit. The estimate was that it would be a 10% increase in the physician fee schedule for Medicare allowed charges.

Since most doctors are employed by a larger healthcare provider and the fees for service are sent to that company and not directly to the doctor, the companies have kept some of the payments meant for family doctors and redirected the funds to specialists thus counteracting the federal government’s intent.

It’s important for the CMS to know what is happening as it considers additional euorts to support primary care. If we don’t support and protect our family doctors, who will we call in the future when our child or grandchild has a temperature? The oncologist?

Write to your legislators and call the Cen- ters for Medicare & Medicaid Services ( 800-633-4227 ) today and tell them to create rules to make healthcare providers pay family doctors more as the federal law intended.

Cheryl Maplethorpe Town of Clifton