The Problem with Primary Care

November 5, 2022

It all begins with an idea. The idea today is primary care has problems and they are rooted in time and money.

Physician’s Weekly, a digital communication, came to me last month with an essay on the problem with high burnout in primary care, low patient access and fewer medical students seeking careers in primary care. The essay seemed well researched using conversations with hundreds of physicians and visits to dozens of practices. The article pointed out that a “clinician working alone would need 17 hours per day to offer good treatment to the average US primary care panel size of roughly 2,000 patients”

The conclusion was that poor funding methods and unstable work life balance issues are at the heart of the issue. I call that time and money. The writers wanted fundamental shifts, calling for higher funding and formation of powerful teams that boost capacity to care for big panels of patients. I say, yes and no and maybe.

Yes, the funding method is a mess. No, powerful teams may not be the answer. Maybe physicians should be directing the change. As long as government dictates funding rules and regulations, we will have problematic primary care.. As long as funding is controlled by health insurance agencies, we will have problematical primary care. As long as physicians are merely employed in the increasing corporatization of medicine, we will have problems in primary care.

Before Medicare and Medicaid, health care was privately funded and was really an unequal mess. When the government stepped in with these two programs, it was supposed to get better for those who were elderly and or poor. I think our health care is still an unequal mess, only now it is government controlled. The solutions are complex but another pathway must be found. Maybe we should just ask panels of primary care physicians to come up with some answers because asking the leaders in government and health insurance industry is like asking the fox and hawk to design a better chicken coop.

Be well and be loved

Sylvia