Direct primary care strikes me as an interesting approach to primary care financing and delivery. I like the idea of a consumer shopping for a primary care facility (or medical home) rather than an insurance plan, and it certainly seems like removing the insurance company as a middle-man could be a cost saver. However, it does strike me that this approach is very similar to that of capitation: a reimbursement method which has been criticized for placing too much risk on physicians or primary care practices and encouraging under-utilization of necessary services. In fact, it seems to me that this system could potentially create the scenario that one of the quoted physicians bemoans: truncated patient visits in order maximize the volume of patients seen in a day (or month).
I did not see these issues addressed in the blog post at hand, however. And perhaps we don’t need to worry about these drawbacks in these instances because physicians would be the administrators of this system. All of the authors in this post seem to suggest that that aspect alone will improve the structure of our primary care system, with Rcentor plainly stating that until we “value the intelligence and knowledge that primary care PHYSICIANS bring to the doctor patient interactions,” we’re destined to suffer “expensive ineffective care.” As though PCP’s will be holding affordable and effective care hostage until they feel that society has adequately paid homage to their superior intellect.
Clearly every system has its drawbacks, and I whole heartedly agree with Rcentor that we need to “think outside of the box” and look for an innovative approach to solving our country’s health care problems. But I would also argue that all parties need to approach these issues with humility and a healthy dose of self-evaluation. With this in mind, I believe that until ALL HEALTH CARE PROVIDERS acknowledge that they are as susceptible to the failings of human nature as any health insurance CEO or claims reviewer we will be hard pressed to find a workable solution to our expensive ineffective care.
Direct primary care strikes me as an interesting approach to primary care financing and delivery. I like the idea of a consumer shopping for a primary care facility (or medical home) rather than an insurance plan, and it certainly seems like removing the insurance company as a middle-man could be a cost saver. However, it does strike me that this approach is very similar to that of capitation: a reimbursement method which has been criticized for placing too much risk on physicians or primary care practices and encouraging under-utilization of necessary services. In fact, it seems to me that this system could potentially create the scenario that one of the quoted physicians bemoans: truncated patient visits in order maximize the volume of patients seen in a day (or month).
ReplyDeleteI did not see these issues addressed in the blog post at hand, however. And perhaps we don’t need to worry about these drawbacks in these instances because physicians would be the administrators of this system. All of the authors in this post seem to suggest that that aspect alone will improve the structure of our primary care system, with Rcentor plainly stating that until we “value the intelligence and knowledge that primary care PHYSICIANS bring to the doctor patient interactions,” we’re destined to suffer “expensive ineffective care.” As though PCP’s will be holding affordable and effective care hostage until they feel that society has adequately paid homage to their superior intellect.
Clearly every system has its drawbacks, and I whole heartedly agree with Rcentor that we need to “think outside of the box” and look for an innovative approach to solving our country’s health care problems. But I would also argue that all parties need to approach these issues with humility and a healthy dose of self-evaluation. With this in mind, I believe that until ALL HEALTH CARE PROVIDERS acknowledge that they are as susceptible to the failings of human nature as any health insurance CEO or claims reviewer we will be hard pressed to find a workable solution to our expensive ineffective care.