1. Mental health issues. I believe prescribing antidepressants similar to throwing darts at a dartboard in the dark. Also, you have to be careful patients are not actually bipolar when they come in for "depression".
2. Having things turfed to you because you are primary care. Specialty is paid the big bucks but you as PCP get to take care of the truly difficult things.
1. the complete siloing of healthcare .. no on takes care of the entire patient (a job primary care is supposed to do but "the time constraints" prevent that) and the ever increasing specialization has too many items fall between the crack or care duplicated.
2. Dealing with the (*&*^) surrounding insurance. eligibility, prior auth for vital medications, the internal silos of the insurance company i.e done part of the company says that expensive medication is a pharmacy benefit, pharmacy bene's say no it is a medical bene, medical says no it is a behavioral health issue, behavioral says it is pharmacy and the circle stars all over again.
3 WAITING ON THE auto attendant to give you enough information to get the person you want just to find the fax umber. We won't even discuss the time getting to a real person for a real discussion.....
Time constraints is a major factor
Underpayment and pace at work seeing a patient in just 15mins though they need more.
Dealing with insurance companies for approval.
Taking work home. You spend more time doing notes at home than you care to. I enjoy my job though.
