Can primary care doctors actually increase health care costs?

Poor McAllen, Texas.

The much maligned city has been in the health policy crosshairs ever since Atul Gawande’s seminal New Yorker article on health costs.

Now, it has the added distinction of being the worst place in the country to live with allergies.

The reason? Apparently, there’s one allergist for the entire city. One. And according to this piece in Newsweek, that means more primary care doctors and non-allergy specialists are treating seasonal allergies, and in most cases, inappropriately.

The thinking goes that specialists can pinpoint specific allergy treatment better than generalist doctors, and thus, can better control symptoms than allergy-ignorant primary care doctors:

In the larger health-care debate, it’s common to hear that an easy way to reduce costs is to limit patients’ access to specialists. Send them to primary-care docs instead, the thinking goes, and they’ll get more preventive care and fewer pricey treatments. That’s true if you’re talking about an illness that responds to cheap preventive measures and is only treated by specialists.

Of course, the article cites data from the Allergy and Asthma Foundation of America, which certainly has a stake in the issue.

Expect the argument that fewer specialists actually increases costs to be increasingly made, especially as specialist reimbursements likely will be disproportionally squeezed going forward.

But is it really true? I have yet to see conclusive data supporting that blanket assertion.

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