Over the last couple of decades the federal government, partly through Medicare, has implemented multiple programs to change how primary care doctors are paid and incent them to deliver better care, with the goal of reducing overall health spending while improving outcomes and health. These programs impose extensive requirements regarding how care is delivered, which results in higher administrative costs for physician practices. Researchers examined a large number of studies evaluating various of these programs. They found that there were significant increases in aspects of processes of care, greater patient engagement and satisfaction with care, some improvement in a few outcomes, some reductions in utilization, but an increase in overall expenditures. If people’s health is actively managed, I have always said you will find that they are missing as much or more care than they are receiving unneeded care. Ensuring that patients get the care they need requires active management and at least initially may raise spending; but in the long run it should reduce spending by limiting chronic disease and avoiding acute episodes of those that exist. (JAMA Article)
Kevin – Curious your thoughts on pro and cons of using primary care physicians?
My personal experience is a mixed bag, mostly leaning to being of little or no benefit (my apologies if my comment comes across as being anti GP)
For orthopedic sport injuries (acl’s rotator cuff etc ), they have been of no benefit,
Similarly Far easier to bypass the GP for specific issues, cardiologist, colonoscopies, etc since the GP provides little benefit for the specific issue.
Though I can see some benefit of having a single doctor controlling/supervising/or just having knowledge of the whole picture instead of being limited to the narrow focus a specialist may have.
Thoughts?
I view a good primary care physician or other clinician as critical to maintaining good health, they should be monitoring health and providing early identification of issues and overall management. The problem is finding a really good primary care doctor may not be easy. I completely agree that for people with a known serious chronic disease, a specialist should be managing that patient’s care, and often for these patients, if the chronic disease is their dominant health issue, the specialist is probably best positioned to serve as the primary care doctor as well.
“The problem is finding a really good primary care doctor may not be easy.’
That is an understatement. Where I live, finding ANY primary care doctor is far from easy.