Report says Indiana health care is over-specialized

Hoosiers see too many specialty physicians and are driving up health care costs as they do, according to a recent study by the Indiana University Center for Health Policy.

Hoosier specialists are paid 84 percent more than primary-care doctors, and that gap has been widening rapidly since the mid-1990s. In addition, Indiana has nearly twice as many surgical specialists (13 percent) as the rest of the country.

The findings aren’t terribly surprising for anyone who has driven by all those heart and orthopedic centers in Indianapolis’ northern suburbs.

But the problem is, the glut of specialists means Indiana has a shortage of family doctors and pediatricians, concluded IU researchers Marilyn Yurk, Kari Christensen and Eric Wright.

"Medical students in Indiana are increasingly choosing to specialize rather than enter primary care," the authors wrote in the report, blaming the pay differences. They added, "it is important for Indiana to address the issue of overuse of specialty care before it becomes insurmountable."

Their suggestions? Encouraging the medical home concept, where one primary care doctor would direct each patient’s care. They also want the state to increase financial aid for medical students who practice in underserved rural and inner-city areas.

They also want state policymakers, somehow, to get the private and federal insurance programs to pay higher reimbursement to primary-care providers.

The average specialist earned $297,000 in 2004, compared with $162,000 for the average primary-care doctor.