Pauline Chen must read my blog.
She talks about primary care in her latest NY Times column, and I’m happy that she uses that lofty perch to re-iterate (much more eloquently) many of the things that I’ve talked about previously.
I especially appreciate how she validates some of my arguments, by nothing the failure of Massachusetts’ health plan, giving fair warning to the Obama administration’s upcoming efforts: “Any attempt to make health care more accessible will be doomed to failure without an adequate number of primary care physicians and a strong primary care system. The situation in Massachusetts should be a wake-up call. Since a landmark law was enacted in 2006 requiring health insurance for nearly all residents, the state has struggled to provide primary care to the estimated 440,000 newly insured.”
She takes it one step further, suggesting that “the crisis in primary care must be addressed before any real change can occur; otherwise, the flood of new patients may instead turn out to be a final strike for our ailing health care system.”
I couldn’t have said it better myself.
Related posts:
- Universal coverage without primary care access is useless
- Improve primary care access before guaranteeing universal health coverage, my address at the National Press Club
- Will the lack of primary care doctors make universal coverage useless?
- Universal coverage and primary care
- Primary care incomes and universal health coverage
- Universal coverage without primary care
- Can universal health coverage be sustained long-term?
{ 8 comments }
Kevin,
You have spoken the truth for a long time about the need for more primary care doctors. Pauline Chen wrote about it, as did Elizabeth Cohen, CNN’s empowered patient. I just hope Tom Daschle and his new team hear that message loud and clear.
Trisha Torrey
Every Patient’s Advocate
http://www.EveryPatientsAdvocate.com
She’s a talented writer but does Dr. Chen actually practice anywhere anymore? Everything I’ve seen about her is so vague on that point. If not eventually her “doctors perspective” will be misleading.
I think there is some confusion here about the real goals of those in power who advocate universal coveage. Some seem to be under the impression that it has something to do with the end result of more actual people getting medical care.
That isn’t it at all. The major corporations want to get their employees health care off their accounts. They know that any public-private joint program will result in the expansion of the former and eventual demise of the later and so will accept is as a transition.
The life-long government service policy wonks are just driven by a primal unconscious desire for power and control even while consciously they tell themselves that they, being morally more pure than those out of government, will find ways to solve all those problems. The real effects of that power and control on other real people are a secondary consideration to it’s origin and their faith will survive failure.
The realists recognize that health care is a private, not a public good and see the failure of a health care system to deliver as a virtue, not a failure—it just means less money wasted on the weak.
The congressmen just want to get reelected and are no smarter than the smuck down the street. They don’t know what they are doing when they do it.
We can solve our preventive care by having patients go to nurse practioners or physician assistants for screening. Most of the time when I go in for my physical i’m seen by a nurse practioner. You don’t need an M.D. to screen for hypertension, diabetes, or test for strep or mono. If intervention is called for, the patient can be referred to a specialist. We cannot say healthcare reform will be a failure without primary care doctors when other courses of action are possible.
Dr K:
why don’t you spend some time with a primary care doctor so you will have a better understanding of what we do?
By reviewing your bio, it is clear that you spent too much time in an ivory tower.
Anonymous,sorry I brused your ego, but who do you think takes care of the poor in areas of the country where most doctors wouldn’t set foot in? Nurse practioners. They care for nearly 20% of Americans who have no access to healthcare. If I had a dime for every medical school applicant who said they wanted to practice in poor rural areas of the country I’d be a wealthy man. We need solutions. Right now most Americans who are fortunate to see doctors only get half the care they should-like I said nurse practioners could do as good.
Dr. K: my ego is just fine.
And you know nothing about me, or the poor town in upstate New York that I practice in.
Which validates my assumption about you: you need to get out of your ivory tower and spend some time with more primary care physicians on the front lines before you can assert an opinion about what we do.
I don’t live in a poor area but have access to great care by an NP. The primary doc’s here are rushed and provide haphazard care.
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