experience each week . How many dozens of chest pain patients have I seen in the last month for whom I did n't order an EKG , get a consult , set up nuclear imaging or send for a catheterization ? Only I have the advantage of knowing how anxious some are and that they have had similar symptoms over the last 20 years . After a history and exam , I am willing to make the call that this is not heart disease . In doing so , I save the system tens of thousands of dollars . Most of these patients are worked into a busy day , pushing me even deeper into that mire of tardiness for which I will be chastised by at least six patients before the end of the day . My reward for working these people in and making the call is at most $ 75 . How many times has an anxious patient come in demanding an endoscopy who I examined and then decided to treat less invasively for three to four weeks first ? Few of these patients are happy no matter how many times I explain that it is reasonable
Editor 's note : Dr. Vance Harris is a primary care physician in Redding , California . An earlier version of this commentary was posted on SERMO.com , a private , physicians-only online community . Dr. Vance Harris says primary care doctors get minuscule payment for saving the system huge sums of money . -LRB- CNN -RRB- -- Health policy experts agree that any reform in our health care system must include a well-educated , caring primary care doctor who is able to manage the health of his or her patients with an eye to using resources optimally to keep costs down . That 's a tall order and it seems that few policy makers realize the value of primary care physicians . People are making a huge assumption in this reform effort that as we extend coverage to millions who do n't have health insurance , there will be doctors there to actually provide the health care . Fewer and fewer medical students are choosing primary care and many primary care doctors are leaving the field . Let me share with you why we are losing so many primary care doctors . What follows are a few examples I