Apropos My Recent Post About the Lack of Leverage in Primary Care (from the Washington Post)
The Appalling Lack of Leverage in Primary Care
A surgeon evaluates patients and performs surgery. But surgeons don’t administer the anesthesia. They also don’t sterilize their instruments or fetch them during the operation nor do they hold the retractors while also cutting or suturing. They also don’t do all the dressing changes and repositioning of patients postoperatively. They move on to other su…
I wrote in September about how surgeons’ time and expertise is leveraged in their specialties while primary care doctors are largely left to fend for themselves, doing many things that severely diminish their productivity and push them toward burnout.
Shortly after I did that, I got an email newsletter that quoted and linked to an article in the Washington Post making the same observation and said primary care is at a tipping point. Today, only 25% of doctors are in primary care. This means there aren’t enough primary care doctors for everyone who needs a PCP (which many insurance companies even require).
The article points out that in 1980, almost 2/3 of medical visits were in primary care and 1/3 were in specialty medicine. By 2013, those statistics were reversed.
This is what the Post states has caused this switch, besides the income inequality between generalists and specialists:
“But the dispirited feeling that drives doctors away from primary care has to do with far more than money. It’s a lack of respect for nonspecialists. It’s the rising pressure to see and bill more patients: Employed doctors often coordinate the care of as many as 2,000 people, many of whom have multiple problems.
And it’s the lack of assistance. Profitable centers such as orthopedic and gastroenterology clinics usually have a phalanx of support staff. Primary care clinics run close to the bone.”
https://www.washingtonpost.com/opinions/2023/09/05/lack-primary-care-tipping-point/
Ultimately, in my opinion, everything goes back to the EMR allowing non-medical entities to control everything. Everybody knows the EMR is killing primary care. The inevitable and predictable result of not letting doctors run their own practices.