Rewarding primary care physicians for time spent with the patient

Abraham Verghese is a professor of medicine at Stanford University, and one of the most articulate physician-writers today.

He recently wrote an op-ed highlighting primary care’s plight, and focuses on the scarcity of time:

The science of medicine has never been more potent – incredible advances and great benefits realized in the treatment of individual diseases – yet the public perception of us physicians is often one of a harried individual more interested in the virtual construct of the patient in the computer than in the living, breathing patient seated on the exam table.Time is the scarcest commodity of all. Patients, particularly when it comes to their routine, day-to-day care, want a physician who has time to understand them as people first, and then as patients.

It’s been frequently discussed on this blog, with solutions ranging from paying physicians per hour to cash only practices.

There’s no easy answer, and worse, money isn’t even the root of the problem.  Often left unaddressed is the burnout that primary care doctors face, practicing in unpalatable environments where the doctor-patient relationship is obstructed by bureaucracy and paperwork.

Dr. Verghese applauds expanding coverage, but acknowledges that significant payment reform needs to come next, writing, “rewarding primary care physicians for time spent with the patient and taking away the fee-for-procedure incentives. Getting to know a patient and having the time to do so is a critical step; I am convinced it prevents unnecessary tests and saves money. It’s just good practice. And it’s what patients want.”

Maggie Mahar recently had a guest piece saying that primary care doctors are being rewarded, to the tune of a 10% increase in Medicare office reimbursements.

Not only is that not nearly enough to sway the tide sinking primary care, it leaves the practice burden facing most primary care doctors completely unaddressed.

 is an internal medicine physician and on the Board of Contributors at USA Today.  He is founder and editor of, also on FacebookTwitterGoogle+, and LinkedIn.

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