Next in a series. Beginning with a deep understanding of medical science and years of training and experience, the primary care physician (PCP) needs to delve deeply into the patient’s personal, family and social setting in order to fully understand the context and causes of the patient’s illness. The PCP also needs to know when it is important or even critical to call upon others with specific knowledge, techniques or ...

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Next in a series. Primary care physicians (PCPs) have multiple frustrations today. The greatest frustration is “time, time, time.” From in-depth interviews with over 20 PCPs, everyone said that time or more correctly lack of time was the greatest frustration of their practice (or was previously if they now were in a practice that limited the patient number to a manageable level). Each knew that they could not give the ...

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Next in a series. As a general rule, PCPs like people. This was true of them long before they started medical school and it will have only blossomed further during training. Ask PCPs, as I have with in depth interviews, and they will tell you that certain types of individuals are drawn to primary care careers. They like to converse with people. They enjoy getting to know about a person -- ...

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Next in a series. The primary care physician (PCP) is the most broadly yet deeply focused care giver and as such is the the backbone of the healthcare system. But to do this work effectively requires time -- time which all too often is not adequately available. What constitutes primary care and who are the primary care physicians? They are the first responders, the first line of care, and very frequently ...

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Next in a series. You the patient are really not the customer of the physician. Since the insurer will determine whether and how much the physician will be paid for attending to your needs, you are largely a bystander in the relationship. The doctor’s customer has become the insurer. Our system of care is definitely not customer-focused. Doctors truly believe that they have the patient’s best interests in mind and they ...

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Next in a series. We have a real paradox in American health care. On the one hand we have exceptionally well educated and well trained providers who are committed to our care. We are the envy of the world for our biomedical research prowess, funded largely by the National Institutes of Health and conducted across the county in universities and medical schools. The pharmaceutical and biotechnology industries continuously bring forth ...

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Next in a series. There is and will be a need for many more primary care physicians (PCPs). Why? There is a shortage now and it will be exacerbated in the coming years for at least three reasons. The population is growing, the population is aging and there will be more individuals with health care coverage as a result of the Affordable Care Act (“Obamacare”). I believe that the need will be much ...

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Next in a series. Primary care physicians (PCPs) are becoming extinct.  It’s true. Not many medical students choose primary care as their career path. Older PCPs are retiring early. Many others are closing their practices or seeking employment at the local hospital. And there has always been a shortage of primary care physicians in rural and urban poor areas. Today only 30% of all physicians practice primary care (compared to ...

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Next in a series. Primary care physicians (PCPs) have too little time per patient which means too many referrals to specialists, too little time listening and thinking, no time to delve into the stress or emotional causes of many symptoms and substantial frustration by PCP and patient alike. Previously in this continuing series on primary care, I described a patient with a straight forward if unusual symptom who was bounced ...

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First in a series. The primary care physician (PCP) should be the backbone of the American healthcare system. But primary care is in crisis -- a very serious crisis. The first statement is my considered opinion and I will attempt to convince you of its truth. The second sentence is a simple fact. Accounting for only 5% of all health care expenses, the PCP can largely control the “if and ...

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