Universal Primary Care

Sarah Rubenstein at the Wall Street Journal Health Blog cites an opinion piece in the Lancet written by four doctors from the American Academy of Family Physicians.  An excerpt:

They suggest some steps to bolster physicians’ interest in primary care: changing payment for primary-care services to make the field more attractive; getting medical students more interested in “generalist” approaches; and supporting training programs for primary care.

A lack of election dialog about the issue has also been a complaint of primary-care doctor and blogger Kevin Pho, as he noted this morning: “The availability of generalist physicians will make or break any plan going forward.” Considering this post we wrote about waits for appointments with primary-care docs in Massachusetts, a state that’s put in place a universal-health plan, Pho may have a point.

Indeed he has.  On the other hand, an anonymous commenter on Dr. Pho’s post makes a good point of his or her own:

Count your blessings, primary docs. The last thing you want or need is for primary care to become a hot topic with the politicos. Better you should withdraw from all govt. encumbrances, go cash only, and serve your patients instead of the insurance companies and the government bureaucrats. As a surgeon, it’s not feasible for me to go to a cash only practice, but a well run primary practice can make it work.

In my own career, I’ve been able to quit a job on the spur of the moment, immediately find work in the area even though I’d just moved there and didn’t know anyone, and simultaneously begin laying the groundwork for my own practice in another state.  So-called cognitive based medical specialties — i.e. those not so rooted to hospitals and expensive technologies that they all but preclude independent practice — offer a lot of versatility and freedom.

This is a primary care “selling point” that is really under-emphasized.

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