If health policy falls, it believes something, it is that primary care is good. In theory, we should all have solid relationships with our primary care doctors. I should be with the health system and get to our doors like Marcus Welby MD when necessary. Winks as I think that if you enter this relationship, patients will receive preventive care, they will get the correct medications and take them, avoid the emergency room and have admissions to the Ferwer hospital, since it will cost a whole except. That is the big theory behind HMO and its descendants of Liter Day, care based on value and academ
Of course, there are decent examples of systems based on primary care such as the NHS of the United Kingdom or Just Kaiser permanent or the Native Health Association of Alaska Slope. But for most Americans, that’s the fantasy land. Instead, we have a system where primary care is the ugly stepson. It is strangling slowly and separates. Only Walmart’s wealth could not make it work.
There are at least 3 types of primary care that have emerged around the last decades. And none of them are very successful in making the idea of ”primary care such as the linchpin of the health of the population.”
The first is the primary care doctor bought by and/or working for the big system. The objective of these practices is to ensure that references for expectations enter the correct hospital system. For a long time, primary care doctors have bones that lose their money money employers said $ 150-250K a year by doctor at the end of the 2000s. So why do they keep them the biggest systems? Because patients who admit in the hospital are incredibly profitable. Consider this NC system that ended in the great atrium of the hospital system because I just wanted references. As expected, the benefits of “cost savings” of primary care are difficult to find among those systems.
The second is urgent attention. Urgent attention has replaced primary care in much of America. The number of urgent care centers doubled in the last decade more or less. While it has pressure tasks in emergency rooms, URgent Care has replaced primary care because it is convenient and can obtain easy quotes. But he is not doing health management and population care. And of urgent care centers are owned by hospital systems that use them to generate private capital references or pirates that try to increase costs, not control them.
Third, Telesalud, especially attached to pharmacies, has allowed many people to get access to medicines in a cheaper and more convenient way. Of course, this is not really a really complete primary care, but Hims & Hers and their many, many competitors are allowing access to common antibiotics for urinary infections, contraceptive pills and also medications for mental health, as well as those erection and baldness pills.
That does not mean that there are port attempts to build new types of primary care
Or of course, this is the United States, you can still get excellent primary care, it will only cost you.
Silicon Valley multimillionaires pay the private year of $ 40ka by Jordan Shlain for the white glove service. At the other end of the scale, a doctor raises $ 80-200 per year of patients who pay for access to the events of the next day, the NP that respond the emails and a free telesalud service for urgent care. In the middle, a large number of doctors who have opted for the discomfort of billing insurers and are charging between $ 500 and $ 5000 a year for concierge care. Then there is a ton of services based on Primary Care, use Telesalud, home visits and NP, or are combined with clinics on the site in workplaces
That the number of those who provide Marcus Welby’s primary care of Marcus Welby in the community continue to fall.
And it is not too difficult to understand why. The average primary doctor does everything less than their specialized counterparts.
Primary care rates are low. The RUC (the update of the relative value scale) establishes that way, which is dominated by specialists and establishes Medicare rates, which are then followed by most private insurers. Therefore, most doctors tend to look at the upper end of this graphic instead of the bottom when they choose their residence spaces. American medical attention is expectation because we have too many specialists who have marginally useful attention, and too many hospitals (and pharmaceutical and devices) make the bank out of them. And everything is related to that graph.
Kff was a rather strange count that said that almost 50% of American doctors were in primary care, but that had many doctors such as “primary care” who do not provide traditional primary care. Of course, this is incorrect, but gives a track for the solution.