Ways to bring back primary care

As the COVID-19 pandemic reshapes the field, the time has come to recenter primary care physicians in healthcare.

In an article for HealthAffairs.org, titled “The Confident Generalist: Putting The Primary Care Physician Back At The Center,” Sachin H. Jain, MD, MBA, FACP; and Balu Gadhe, MD; make the argument that primary care physicians have ceded some of their primacy in healthcare to specialists. This has led to a massive outsourcing of care to specialists which in turn may have driven up the cost of care and may even negatively impact patient health outcomes.

The authors say that the way to combat this supplier-induced demand is to create more confident generalists. They presented a number of ways to do this:

• Economic incentives: Fee-for-service models incentivize outsourcing to specialists, but newer payment models could create an atmosphere where primary care physicians are rewarded for value creation without constant referrals.
• Medical education reform: Medical education should be reoriented around primary care including medical student loan forgiveness for those who go into primary care.
• Expand Medicare Advantage use:Systems should launch their own plans or accept full delegation of global risk from those which already exist.
• eConsult use expansion: Through the use of econsults primary care physicians can quickly receive information without triggering a patient consult.
• Refocus and repurpose CME: The programs can be used to increase a primary care physician’s knowledge and confidence.

Read the whole article here.