Health Beat: The Front Lines of Primary Care: The Stories Behind the Crisis

[deleted87716]

Part I: http://www.healthbeatblog.org/2008/11/the-front-lines.html

Yeesh...

In Part 2 of this post, I'll talk more about the reality of primary care—including its upsides—and how we can create a health care system that nurtures PCPs instead of breaking their spirits.

I look forward to reading Part 2.

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[deleted87716]

Here's part 2...

http://www.healthbeatblog.org/2008/11/the-front-lines-of-primary-care-part-2.html

 

[andwhat]

Here's part 2...

http://www.healthbeatblog.org/2008/11/the-front-lines-of-primary-care-part-2.html

yup, some facets already implemented, with the notable exception of the pay increase.
in the Community Clinics, the M.D.s spend time with the most complicated patients, seeing 25-30 or even more per day.
The P.A.s and N.P.s see the sore throats, certain disability examinations, etc.
Its getting tougher and tougher-- clinic medicine that is.
How in the world can you possibly have time to hear about 17 complaints, in a 15 minute time slot? Wow...
Some outpatient Medicine clinics, are rewarded for doing the least amount of work for the patient as possible, in the quickest amount of time, so that more patients can be seen.
This is quite a sad sad outlook at times.
Ok the pay differences, they do exist.
However, Specialist Overhead is probably much higher, and they work much longer hours, and many many more nights. Vast majority of Hospitalists, after a year or so, admit that they would not want to go back to any specialty.
Clinic Medicine integrating a Hospitalist system to admit their patients, so they can work in clinic all day only -- these Physicians also have relatively high job satisfaction. Heck that would be quite sweet honestly, phone on call only. "Go to the ER."
Urgent Care -- obviously no Hospital work whatsoever -- also quite high job satisfaction.
It is about money, as well as Lifestyle issues.
I am anxiously awaiting the pay increase in Clinic Medicine. Hospitalist Medicine is very nice, but it will be very interesting to see how things work out. However, that being said, I heard that the complete change will be around 10 years. Wow, that will be unbelievable. The masses lining up at the ER to gain access to Primary Care. There is no such "Primary Care shortage". It is the system that needs to change, and it will certainly not change overnight. The problem is "overpaying the specialist" Nobody wants to address this, so Primary Care will not change.
Vast majority of Physicians, I would imagine, enjoy being free of the hassles of the Emergency Room. This is a nice plus, for Physicians that use a Hospitalist System as well.

 

[Joe Richards]

Each year more people are using chiropractic doctors as their PCP. They research DC's and choose those well enough rounded in primary and regularly refer to an MD.
Had a few patients reffered by their DC. They had a very high satisfaction rate so I cross referred. Working out ok for now.

Just out of curiousity I have a couple of questions.

1. "well enought rounded in primary"??? since they have no formal medical training (residency, medical school, pharmacology, etc.) how exactly are they "well rounded" in primary care? Just because they can manipulate the spine that makes them primary care?

2. How exactly do you cross refer? Do you send them your back pain patients or all your patients. do you share primary care patients?

3. Just because someone is satisfied by their DC does it mean that the DC did them justice? Define satisfied and in what way?

 

[andwhat]

Just out of curiousity I have a couple of questions.

1. "well enought rounded in primary"??? since they have no formal medical training (residency, medical school, pharmacology, etc.) how exactly are they "well rounded" in primary care? Just because they can manipulate the spine that makes them primary care?

2. How exactly do you cross refer? Do you send them your back pain patients or all your patients. do you share primary care patients?

3. Just because someone is satisfied by their DC does it mean that the DC did them justice? Define satisfied and in what way?

absolutely preposterous ha ha Chiros are great at adjustments, but stating that they do a 'good' service untowards Primary Care, is a horrible statement.
I just know that somebody is going to fly in here, and state
"Chiros are great doctors, and I would rather see them than House, you are just jealous!!!"
Oh man.... the things that I am hearing...
Chiros cannot write prescription medications. They have been battling this for decades, without any success.

 

[deleted87716]

 

[andwhat]

agreed....