In the hoary days of my youth in a modestly sized town (about 6,000 people) in Iowa, before I moved to Ames...
When we needed to go to the doctor, it was a small office with a single doctor.
This doctor was not the only such practice in this smallish town.
The staff was his secretary/receptionist and a physician's assistant.
That's it. Three people and a clientele of about 1,000 patients of all ages.
My mom's income was just slightly above the point where a (newly) single mom with two kids would get government assistance, and we didn't have health insurance.
Yet we were able to afford to go to the doctor.
I've looked around and this sort of practice is gone.
The smallest I've been able to find still has 15 people working there.
This leads to some sickening comparisons.
The 15 person staff is servicing the same number of patients as the 3 person.
The secretary/receptionist at the GP way back had no medical training or certifications.
All 12 of the non-doctor positions at the 15 person practice have at least a medical assistant degree and certification, and you cannot work at an office without it. Most of them also have a specialized certificate/degree in medical billing and encoding.
What changed?
Laws and regulations mostly. Thanks to all that increased regulatory overhead, you need five times the personnel and three times the doctors to treat the same number of people. On top of that, the front office people need to be trained in skills they will never use.
This is akin to requiring the receptionist at a law firm to pass the bar so they can be hired to answer the phone.
When we needed to go to the doctor, it was a small office with a single doctor.
This doctor was not the only such practice in this smallish town.
The staff was his secretary/receptionist and a physician's assistant.
That's it. Three people and a clientele of about 1,000 patients of all ages.
My mom's income was just slightly above the point where a (newly) single mom with two kids would get government assistance, and we didn't have health insurance.
Yet we were able to afford to go to the doctor.
I've looked around and this sort of practice is gone.
The smallest I've been able to find still has 15 people working there.
This leads to some sickening comparisons.
The 15 person staff is servicing the same number of patients as the 3 person.
The secretary/receptionist at the GP way back had no medical training or certifications.
All 12 of the non-doctor positions at the 15 person practice have at least a medical assistant degree and certification, and you cannot work at an office without it. Most of them also have a specialized certificate/degree in medical billing and encoding.
What changed?
Laws and regulations mostly. Thanks to all that increased regulatory overhead, you need five times the personnel and three times the doctors to treat the same number of people. On top of that, the front office people need to be trained in skills they will never use.
This is akin to requiring the receptionist at a law firm to pass the bar so they can be hired to answer the phone.