Ways to make primary care the key to health reform

Posted by: admin on: April 26, 2011

America is closer to meaningful health care reform than at any time in its history. Finding a way to both provide every American access to affordable health care while seeking to control health care costs has not been easy. One goal all sides can agree on, but have yet to meaningfully address, is the need to end the crisis of primary care in the United States

In a survey from the Journal of the American Medical Association, 94 percent of patients preferred seeing a primary care doctor first for their medical issues .But in most cases, patients wait weeks or months for a primary care appointment, which often leads them to the emergency department for care that ordinarily can be handled in a doctor’s office.

Many solutions propose to rectify the economic factors, such as lower salaries, that discourage medical students from pursuing careers in primary care medicine. But there is scant discussion of rebuilding our health care system around the primary care doctor-patient relationship. To achieve this, three ideas are essential: teamwork, technology and integration

Nurses huddle with their doctors prior to each visit and summaries of patients’ lab tests, notes, current medicines and problems are reviewed. Receptionists are also involved, scheduling lab tests before and after encounters to ensure that doctors and patients have the information they need at each visit to change the plan of care.

Technology already plays a prominent role in medicine. One example is simple e-mail, which is beginning to make inroads in health care.

If we build a health care system around the primary care doctor’s office, then all other facets of care must be integrated with it. Specifically, involving specialists in the primary care experience can provide comprehensive care efficiently.

At Kaiser Permanente in Northern California, specialists have introduced “p-consult” to provide this kind of integration. When a patient comes to see their primary care doctor with a problem that requires specialist input, the primary care doctor can call the specialist immediately from the exam room for consultation

Both primary care doctors and patients report that the program helps them get care right the first time, avoiding redundant visits and tests that drive up costs. For specialists, “p-consult” helps keep their access open for patients who need to be seen

According to the World Health Organization, health care systems centered around primary care have lower costs and better outcomes

Now that USA has also realized and accepted that Primary care is the key to better health, we in India should push for more doctors entering family practice and family physicians striving to deliver better and more diverse healthcare.

Ref: http://www.kevinmd.com/blog/2010/01/oped-ways-primary-care-key-health-reform.html

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