Solving the primary care crisis
The root of the problem is that insurers have paid relatively little for primary care, placed ever increasing non-clinical work burdens on the PCP, and created billing and coding conundrums that have forced rapid escalation of overhead costs. As in any business this means trying to “make it up in volume.” More patients seen per day (25 or more) means less time per patient (often only eight to 10 minutes of “face time”).
PCPs are generally thought of as only dealing with the “simple stuff.” But PCPs are trained to manage complex chronic conditions such as heart failure and diabetes — the illnesses that cost about 70 percent to 80 percent of the health care dollar. This takes time and requires listening and thinking. This is especially true with a geriatric patient with multiple chronic illnesses, taking five or more prescription medications and having difficulty with hearing, vision or perhaps cognition. It also takes time to develop a real relationship between doctor and patient, the type of relationship that allows and encourages trust, empathy and healing.
What can be done to assure comprehensive primary care? There are multiple innovative approaches that can work. Each allows the PCP to see fewer patients for longer periods yet earn a similar income. Here are a few innovations, mostly selected from in Maryland.
Some PCPs are forgoing all insurance billing and reducing the size of their practice from the usual 2,500 to 3,000 or more to about 500 to 800. They can then offer same or next day appointments — reducing the need for E.R. or urgent care visits. The appointments are much longer, allowing for clinical problem solving, as opposed to the PCP serving as a referral engine to specialists. Some offer generic drugs at wholesale prices and reduced-fee laboratory and radiology testing. These services are offered for a fixed fee, with no co-pays or deductibles. Called
Catonsville-based Erickson Living retirement communities set the ratio of residents/patients to PCP at just 400. This assures the close relationship and quality care that older people need, including a focus on prevention and chronic illnesses. The
Medicaid-covered individuals often get limited care;
The message is clear. Comprehensive primary care through reducing the patient-to-PCP ratio and offering the patient more time per visit leads to much better health, more satisfied doctors and patients, and substantially reduced total costs of care.