NEJM: Primary care in crisis
Primary care is facing "a confluence of factors that could spell disaster," including inadequate reimbursement, uneven quality of care, and a drop-off in the number of generalists graduating from U.S. medical schools, according to an editorial published in the August 31 issue of the New England Journal of Medicine.
Although a majority of patients prefer initial care from a primary care physician, patients are dissatisfied with their primary care experience, the author, Thomas Bondenheimer, MD, writes in the editorial. Primary care physicians are dissatisfied with excessive work demands and an inability to provide the highest quality of care to patients with chronic conditions.
Physician payment systems do not adequately reimburse for the types of services primary care is best at providing-preventive and evidence-based medicine. Consequently, between 1997 and 2005, the number of
According to the editorial, primary care has the potential to reduce costs while improving quality. States with a higher ratio of generalist to population have lower per-beneficiary Medicare expenditures and higher scores on 24 common performance measures than states with fewer generalists and more specialists per capita.
To read the article, click here.