Is primary care set for a turnaround?

The recent news is certainly grim.

Almost half of primary care doctors want to quit. Only 2 percent of internal medicine residents want to enter the field.

Yet, I think there will be a turnaround ahead, if only because we’re close to the bottom.

Here’s why. The powers that be, President-elect Obama, and influential Democrat Max Baucus, have shown that they seem to understand that primary care is the pillar that will support their health reform initiatives.

By almost any metric, systems that utilize more primary care services operate at lower costs and have better quality outcomes. Both those factors are key buzzwords that will get attention in the current economic and political climate.

Access to primary care is already at a premium, with the influx of Medicare patients yet to come. Seniors seem to understand the impact of the primary care shortage, as the AARP has allied with doctors in protesting Medicare pay cuts.

For medical students brave enough to enter the field, they are finding that the shortage is working in their favor, and are able to dictate their terms in a buyers market for primary care.

Nurses and mid-level providers, who some feel are able to “replace” primary care doctors, have shown absolutely no interest in doing so.

The ACP feels the same way. They have released a white paper (seems to be in vogue these days) that in lobbyist Bob Doherty’s words, “makes the positive case that primary care will improve outcomes and lower the costs of care.”

That’s important. Physician complaints about being underpaid will not resonate with the public, who seem to think that all doctors are millionaires.

Generalist practice has to be framed in such a way that it will benefit patients, lower health care costs, and improve quality outcomes. It should not be difficult for primary care to make the case on these points.

Bottom line: should you buy, sell or hold primary care? While it may be overly optimistic to suggest “buy,” I think future generalist practice warrants a solid “hold.”

topics: primary care, acp