A nice op-ed in Forbes.com outlines some basic strategies to revamp our generalist system.
Two suggestions, increasing payment and addressing defensive medicine, are not new and I certainly agree they need to be part of the answer. They have been discussed comprehensively in my past posts.
One idea, allying with retail clinics, is something that many physician groups foolishly oppose. But as the opinion piece asserts, “basic care is better than no care at all,” and patients will eventually find their way to these venues if primary care access continues to be poor.
Hospitals and physician offices need to form alliances with retail clinics early on, or else corporate entities like Wal-Mart and CVS will start to have a growing influence in the health care debate. And you can be sure that their interests certainly won’t include the welfare of primary care doctors.
Related posts:
- Should primary care doctors embrace retail clinics?
- Are retail clinics living up to expectations?
- Retail clinics
- Retail clinics and cherry-picking
- Retail clinics are not for patients with chronic disease
- Retail clinics and disruptive innovation
- How retail clinics will harm primary care and the public good
{ 6 comments }
We’ve been embracing customer service for decades now and I agree we should continue to do it wholeheartedly, because that is our ultimate trump card. Wonks gripe alot about our system but for those with insurance we as doctors are more responsive to patients than anywhere else. They are catered to like no other country. If healthcare reform is passed that is not agreeable to us we take customer service away and let the wonks deal with the aftermath and let them plug that into their charts and graphs.
News flash: retail clinics and urgicares do not decrease health care costs. Anybody who has worked at either knows that the bulk of pateints seen at these places DO NOT NEED TO BE SEEN AT ALL. And if there is an urgent issue, they are usually quickly turfed to an ER or a real doctors office.
Stop drinking the kool aid.
In my office, every single patient who wants to be seen is offered an appointment either same day, or if they call late in the day, within 24 hours. This just may not be soon enough for many patients who crave convenience and think their doctor is the problem if they cannot be seen whenever they want (concierge medicine anyone?).
To be honest, I do not see any significant difference between retail clinics and urgi care medicine other than aesthetics. Therefore, I am not in the least bit threatened by them. Urgicares are the ones who should be nervous.
Retail clinics are nothing more than a band aid that enables a broken system to limp along. We would be far better off treating the underlying disease, a shortage in primary care, than merely covering up the symptom–poor access.
As a layperson, I am getting a bit confused about market forces. All these medical students are leaving primary care for specialty care, yet most Americans have health insurance and most health insurance requires the insured to have a primary care gatekeeper. Where are all these people coming from who will need/want so much specialty care and will have access to it without a PCP? It seems to me that the market would force some doctors back into primary care simply because our society cannot sustain an indefinite number of specialists with cash clients, or even a huge number of concierge PCPs given the large fees most of them charge. What am I missing here?
Your premise is off. Most insurance plans do NOT require a PCP. They all recommend one but after the public relations fiasco of the mid 90’s when “gatekeepers” were required nearly all plans offer options that do not require a PCP. Medicare (except for the Advantaged Care plans) does not require a PCP. Most patients wanted the ability to go directly to a specialist if they felt that was what they needed…So specialists are still getting reimbursed by insurers but they can be accessed by slef direction from patients
“In my office, every single patient who wants to be seen is offered an appointment either same day, or if they call late in the day, within 24 hours.”
Where I live, it will take 2 months for a non-urgent problems, passed off to the urgent care for anything that needs care sooner than that. The last time I called my doc-for a breast lump-she didn’t have time to see me. It seems to me that I am the inconvenience.
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