AS REGULATION AND RED TAPE GROW, DOCTORS COPE BY JOINING GROUPS

Cape Girardeau's largest medical group is expanding in an effort to improve local access to primary-care doctors. We welcome this move if it can bring more family doctors to town. Cape Girardeau -- and much of the nation -- continues to suffer from a shortage of family doctors. Several primary care doctors have closed up shop in recent years, making the shortage in this area even more acute. Many new residents -- especially Medicaid patients -- are finding it virtually impossible to secure a family doctor or pediatrician.

The Internal Medicine Group is adding two local doctors to its staff in the next several weeks, and moving three pediatricians to the former Community Counseling Center. They also plan to add an another family doctor to the group in July.

Several other groups are working diligently toward the same goal -- including the Cape Girardeau Chamber of Commerce, our two hospitals and the Cape Girardeau County Medical Society.

While we welcome the move to strengthen our local primary care access, we lament the passing of another era - that of the solo practitioner. Each year, the number of private practices diminish. Much of the reason can be linked to burgeoning regulations and endless paperwork. Most doctors are required to have several employees just to make sure all the forms are filled out properly. Medicare and Medicaid are especially burdensome.

The fact that these government programs create massive paperwork and less than adequate compensation have worried many doctors about the fate of medicine under Clinton's reform plan. When government intervenes in any program, things seldom become simpler. Some doctors may fear that reforms may place more control on medicine with fewer choices for private individuals. They may see joining large groups or hospital staffs as a way to cushion some of the coming changes. Groups often offer members more bargaining power and job security.

One of the family practitioners making the move, Dr. Michael Wulfers, feels that doctors in private practice are a dying breed due to all the regulations. Every doctor today requires three or four people for staff support, due much in part to the sheer paperwork. Wulfers feels that within five years, solo practitioners may become a thing of the past.

The shift away from private practices probably won't bring drastic changes in our medical treatment. Just because a doctor is in a group doesn't mean they can't offer personalized service. But the days of old-time "family" doctors who could do everything -- treating all of the "specialities" and making house calls -- have virtually disappeared. And with that has gone a measure of familiarity.

Doctors in solo practice today also have more trouble absorbing the growing cost of running a medical office. For example, the cost of insurance coverage have forced many family doctors to quit delivering babies. With changing medical technologies and mobile families, we are also coming to expect more from doctors -- and are not so tied to one doctor in our lifetimes.

There's little doubt, regulations and societal changes have turned medicine into simply a business, and that's a shame. The personal connection between doctor and patient remain a critical facet of treatment.

In the coming years, it appears America's health care system will undergo extensive reforms. Most agree that the cost of medical treatment is too high. Reducing costs while maintaining quality will certainly be a challenge.

We're glad to see the push to bring more family practitioners to town. It's wrong that many who can pay for care still can't find a doctor. That offers small hope for those who don't have the means to pay.

We feel this push for new primary care doctors should strengthen Cape Girardeau's standing as a medical center, and provide better opportunities for area patients.