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Carl Blesch's avatar

Dr. Duvefelt, I greatly enjoy your posts, but I must disagree with you about this one.

My decades as a PA taught me something very important: While I might be adequately trained to do 80%+ of primary care, the more advanced training of a physician is needed to recognize that occasional patient whose uncommon diagnosis is masquerading as something more pedestrian. Physicians in primary care of any sort really do practice at the “top” of their licenses because they are must recognize and properly approach unusual presentations and uncommon conditions, including those that may be outside of their primary care specialty.

Hans Duvefelt, MD's avatar

I think we actually agree. My point is that in today’s fast paced practice environment, data entry and nurse/public health work makes it hard to fit in deep thinking and research:

https://acdw.substack.com/p/doctors-and-ceos-need-time-to-think

M J's avatar

Thanks!

Could you expound on reimagine, reinvent, reinvigorate!

Hans Duvefelt, MD's avatar

A favorite concept of mine. I’ll write more about this. Why do we call it insurance and why does it have anything to do with where we work? Why does my employee insurance have an $8,000 deductible when the average health care cost in this country is about that? Why can’t most practices solve problems over the phone and get paid for it? And on and on…