A nice summary of recent commentary, as well as a proposal:
If physicians don’t want (or are unable) to practice primary care, why fight it? We have very capable individuals who could step into the roles of primary care that are most needed and do a wonderful job. Redefining primary care functions, and those who serve in the roles, is a needed change in our system.
Related posts:
- Primary care doctors struggle to survive, even in Beverly Hills
- Will the Baucus health plan save primary care?
- The primary care problem
- Older primary care doctors can’t retire
- Primary care handymen
- Why primary care matters
- Universal coverage will fail without fixing primary care first
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This is an absolutely horrible idea. So instead of paying primary care appropriately, we decide to throw in the towel and let mid-levels take over a centuries-old profession?
Regardless, I doubt this will fix the problem, which is the undervaluing of the medical doctor’s services in primary care. Am I really to believe that the gap between the exorbinant subspecialist salaries and the ever-falling primary care compensation will close when 3 APNs are working under an internist? What color curtains have you picked out for your House of Lies?
The reason this idea is being pushed is because it would save hospitals money by being able to get away with paying nurses for trying to do a physician’s work under the guise of it being “supervised” by a “collaborating” physician (i.e. a doctor not even on the premises). My hospital in particular wants to do this so that they have leverage over PCPs who want equitable compensation by threatening them with replacement on the cheap.
You don’t think the insurance companies are eventually going to say, “Well, now that you’re billing 40% more visits, and they’re being seen by APNs, we’re going to pay you less unless the doctor actually touches the patient.” Then what?
Medical students aren’t dumb. They see the ridiculousness going on. Pay primary care what it’s worth, or stop complaining when everyone continues to go to the ER for primary care.
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