Robert Centor wonders if the same forces can help outpatient physicians.
The problem with that model is that only physicians can do hospitalist medicine.
That’s not true with primary care, as mid-levels are increasingly pick up the slack. Hospitals are likely going to hire more PAs and NPs, rather than paying physicians more.
Which is why it is important for patients to realize the value of having a primary care physician.
It will be the public who will have the final say. If they embrace the mid-level model of primary care, the days of physicians entering primary care are certainly over.
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{ 2 comments }
I am still cynical.
As the article points out, hospitalists need to be subsidized and this subsidy has increased recently.
Right now there is a demand, but eventually the market will be glutted with disillusioned primary care doctors.
Plus, there still is no significant data that hospitalists improve quality and/or decrease costs. Many studies have not shown a difference between hospitalists and community attendings. Those that have are debatable.
There is no substitute for continuity of care.
A note of alarm to my fellow primary care doctors, particularly the younger ones: you may think that giving up hospital care will improve your quality of life and bottom line, but, in reality, you are just making yourself more easily replacable.
A worried family practitioner
There’s no question any patients just want their antibiotic for their cold, rash, bug bite, etc. or to get a referral to see a specialist. They (and BCBS/Medicare/Medicaid) will be more than happy with the midlevels.
The question will be how many patients will see value in having a generalist physician and be willing to pay extra for this level of care. Those few patients will expect a higher level of customer service than is found in most third party payer dependent practices.
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