A Primary Care Vision

Healthcare is changing again.  There is a movement away from fee for service to global payments for care.  This means that the insurance companies give a provider or practice, a set fee annually to cover an individual.  It is the responsibility of the provider to manage medically and keep costs down.  If a practice goes over the amount, it is then their responsibility.  There are exemptions, of course.

This concept puts the responsibility in the hands of provider to help maintain patients health through good preventive care like regular diabetes, cholesterol and cardiac visits.  It is based on the research that preventive care reduces adverse events because potential problems are identified early on.

There are pros and cons to this approach.  One of my concerns is, will it put undue to pressure on primary care providers to limit some testing.  I wonder if providers will hesitate to order investigatory tests to get to the root of a complicated problem and choose to follow a more conservative approach.  I see it now in practices a much longer, let’s wait and see approach to care which often puts the patient at risk.

What I am really hoping for, and believe this concept has the potential for is, primary care providers (PCP) will get to know their patients better.  I would like to see PCPs more involved in patient outcomes when sent to a specialist.  I find when a client of mine goes to a specialist, the PCP is often the last to know what has happened.  They don’t always get the information from a specialist in a timely fashion.   I would like the PCP to be involved in decision making with the patient, to hold the reins of care and be a major part of the team, not just the gate keeper.

I would like to see PCPs have the respect they so deserve.  I know it is a difficult job but they are rarely given the appreciation in the medical world especially with specialists.  Primary care is the essential part of  a patient’s care and any way the healthcare can acknowledge that would make me happy.  If these type of payments achieve that, then I support it.