Can primary care only innovate in large practices?

It sure seems that way.

A perspective piece in the NEJM talks about “innovations” like telephone medicine, communicating by e-mail, physician-nurse teamlets, group visits, and part-time schedules, all designed to reduce primary care burnout.

All the cited examples were large physician groups, which pretty much ignores 90 percent of the doctors in practice today.

The ideas that work in a Mayo or Kaiser setting can’t realistically be applied in solo or small-group practices, which accounts for the majority of physician environments nationwide.

Moreso, these “innovative” practices are still facing recruiting difficulties. Jaan Sidorov observes that “if large group practices, nurse teaming, scheduling know-how, remote care communications and group visits are all that cool, then why are young physicians not flocking to [these] large group practices?”

topics: practice, primary care

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