Here’s a good take on our specialist-based health system. In most countries, the ratio between generalists and specialists is 80:20, and it’s almost the opposite here in America. Wendy Lynch wonders why primary care is shunned in medicine, but valued everywhere else:
For example, I use a wonderful handyman, Jim, when things go wrong at our house. He is a former contractor who has experience in plumbing, electrical wiring, heating, roofing, tile, and many other general fix-it talents. His best attribute, I think, is an ability to know””or quickly assess””whether a problem is serious. Because Jim knows our house, he occasionally notices a loose board on the deck or a leak somewhere. This allows us to fix things we wouldn’t have otherwise noticed until they grew worse. The WORST news I can get from Jim is “you need a specialist,” because that means the problem is likely serious and expensive. Because I pay for it myself, I want expertise, but at a reasonable price.
Nice analogy.
Related posts:
- Academia responsible for the primary care shortage?
- Op-ed: Shortage of primary care threatens health care system
- Is money enough to save primary care?
- Primary care physician salaries
- The "right" to health care
- When specialists provide primary care, and why patients aren’t complaining
- Ted Kennedy’s care
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The explanation by physicians is that primary care is not as lucrative as being in one of the specialties, especially one that is procedure oriented. Reimbursement from insurance companies and the government is based on how many procedure you do. This leads to overtreatment, safety concerns, and added expense (to the tune of $770billion a year). Primary care docs rarely do procedures, and insurance doesn’t pay much for office visits; therefore their salaries are about 1/3 those of specialists. In most European countries all doctors are paid the same, but they can get bonuses by providing quality care. Primary care doctors are at the front line of our healthcare system; they prevent chronic disease by intervening before the disease has time to progress. They coordinate care for patients among all the specialties and subspecialties, thereby avoiding duplication of treatments and medications. When you think about it, it is easy to understand why Europe has cheaper and better healthcare then we do in the USA. For more discussion, please see http://takingcontrolofyourhealthcare.com/.
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