The future potential for primary care

Key Points

Economic forces are splintering healthcare. Although the turmoil created by this market shift focuses on reducing overall costs in the most expensive delivery system in the world, it ultimately will force its reorganization around primary care, not hospitals.

Why? It's a matter of economics.

And although the state of primary care today seems like a losing proposition to some, the game is changing, Flower says, and history will show that 2010-2012 will be marked as a kind of tipping point.

In the coming years, primary care physicians (PCPs) will take their place at the center of the healthcare delivery system, and this change will usher in a new era of team-based, coordinated care that will lower healthcare costs overall and level the playing field regarding disparate salaries for PCPs compared with their specialist colleagues.

"In all of the countries in the world that have a more streamlined and efficient healthcare delivery system, primary care is very, very strong," Flower says. And as most PCPs have always known, they are members of the specialty trained to evaluate a patient's overall health status and co-morbidity-something a heavily specialized healthcare delivery system fails to do effectively.

The healthcare system, as it is structured today, centers on the relationship between hospitals and specialists, Flower says. "Primary care has been seen as the feeder mechanism to bring patients into that core. The new center of healthcare will be organized around primary care, and the hospitals and specialists will be seen as adjuncts to help PCPs care for their patients. This is a very large and very significant shift," Flower says.