It’s not often that such an uninformed, inflammatory op-ed makes a clinical publication, but Jonathan Glauser, Chair of the Emergency Services Institute at the Cleveland Clinic, sets the standard for contempt with his anti-primary care rant.
Here are some responses from around the blogosphere.
ACP’s Bob Doherty: “To put it as kindly as I can, it appears that Dr. Glauser didn’t do his homework.”
Rob Lamberts: “Emergency Medicine News should edit more carefully. This is destructive ranting at its worst.”
Fellow emergency physician Shadowfax: “But Dr. Glauser is not just wrong, he’s cringe-inducing in his ranting. As they say on the interwebs: Epic Fail.”
Robert Centor: “This is too ludicrous to induce my comments. Not all physicians have common sense. Not all physicians understand health care.”
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{ 8 comments }
Another emergency physician’s comment at http://www.emedconcepts.com/2008/12/primary-care-ba.html
One ED doctor makes a stupid post bashing PCPs and the entire blogosphere apparently explodes in outrage. You exceed that number of posts bashing specialists most days on this blog alone. Bit of a double standard there.
Anon 7:49…the difference is that we’re right.
And by “bashing specialists” I take it you mean “proposing a reduction in the unreasonable income disparity enjoyed by specialists”
Personally, I’d like to close the gap by seeing primary care incomes rise. But at this point, the priority is on closing the gap by any means necessary.
The unfortunate thing is that it isn’t just a
“stupid post,” it’s a so-called article in “emergency medicine news.” It would be different if it were a blog post. Not only did Glauser write this opinion piece, but the editors of the news magazine for which it was written found his opinion to have enough merit to be published.
I think the guy is right. We shouldn’t be spending a significant amount of money on doctors that only conduct physicals, and write out scripts and referrals
While the Primary Care Physician industry is certainly loaded with brilliant and talented doctors, PCP’s by nature are unable to rely on the specialized testing needed to make a full diagnosis. And the clinician who possesses the experience and intuition needed to paint an accurate portrait of a patient’s health, aided only by the broad brushstrokes of a medical history form, a resident-administered physical, and the 15-20 minutes of actual face time that is allotted to each appointment (scheduled weeks in advance), is a rare breed indeed.
Primary care docs who practice like that have just adjusted to the rules of the payment game: the more you push through, the better you get paid. I don’t think it’s right, but that’s what the system values. Change the payment system to value something else and you will get different behavior.
While I found Glauser’s rant completely unfounded, he exposed a tension between specialists and generalists that has been present for some time. As we may be beginning the process of health care reform such infighting may worsen as primary care looks to reassert itself and, justifiably in my family doctor opinion, take more of the pie. I posted on this a few days ago as well on The Country Doc Report (http://thecountrydocreport.wordpress.com/2008/12/27/head-of-er-docs-family-docs-exchange-words-over-medical-home/)
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