Connecting with Primary Care: Let’s Switch the Emphasis to Prevention
Posted: December 30, 2022 | Category: News
Family medicine takes the frontline position in forward-thinking, pro-active health care
By Joseph A. Habig II, MD, Family Medicine Physician and Medical Director, Valley Preferred
U.S. adults who have a primary care physician have 33 percent lower health care costs and 19 percent lower odds of dying than those who see only a specialist. As a nation, we would save $67 billion each year if everybody used a primary care provider as their usual source of care.*
The concept of primary care is one that’s absolutely necessary for any progressive vision of the future. This is evident even though some people may associate primary care physicians (PCPs) with doctors who, years ago, visited your house and discussed your condition over a cup of tea. However, if we borrow the sense of personal connection that was inherent in those past physician-patient relationships, and apply it to today’s technology-driven medical practice, we arrive at a more evolved version of informed, compassionate, holistic patient care. This version is essential, as people increasingly value a sense of humanity in their care, and physicians try to rediscover the joy of practicing medicine despite their increasing administrative and technological responsibilities.
Why is primary care so important?
One answer to that question is that seldom does an illness or medical condition exist in a vacuum. In other words, the systems in the body and mind are all connected and one can, and usually does, affect the others. PCPs have the unique advantage of having studied all the systems of the body, and, especially in recent years, have incorporated how behavioral health comes into play in any given condition.
The COVID-19 pandemic underscored this advantage when patients continued to develop symptoms in various parts of their body. Some had arrhythmias, heart, or other organ damage. Some had headaches, blood clots, rashes, swelling, or strokes. Many had no symptoms at all. This situation exemplifies the need for a physician whose knowledge extends beyond one specialty. It also speaks to a physician who is familiar with his or her patients, has a long-term relationship with them, and therefore knows when something is awry.
Another reason primary care is important is that health care is in the process of switching to a value-based model of reimbursement, which is expected to be significant in the future. Since value-based care transfers the emphasis from diagnosing sickness to keeping people well, primary care takes a frontline role. The primary care office serves as ground zero, where the physicians and staff can get an early jump on a problem that could become a serious health threat if left unattended.
From the physician’s perspective
In order to bring more value for patients into the health care equation, it’s imperative that physicians work together. From the insurer’s point of view, physicians and their staffs are part of a team of hundreds of physicians managing a population of patients. Since patients are attributed to their PCP, what happens in the family medicine office is of utmost importance. As the PCP pursues quality in practice (completing annual wellness visits, closing care gaps, monitoring episode costs, and coding accurately), economies can result that ripple across the population.
For example, if during a wellness visit, a patient mentions bowel changes, the PCP can prescribe a colonoscopy. If during the screening, early colon cancer is diagnosed, then cured, it may contribute to overall cost savings. Contrast that to a patient who did not visit a PCP and their cancer advanced undetected. This would take more resources and potentially cost more to treat and manage.
Another example is when a patient visits the primary care office rather than going to the Emergency Department (ED) in the hospital. Many health problems can be initially addressed by a PCP, and PCP visits are less expensive than ED visits for patients and insurers.
Primary care in transformation
The field of primary care continues to be challenged. Fewer medical students are taking this route, contributing to what has been estimated as a shortage of 21,000 to 55,000 physicians by 2033**. However, this field is ripe for change and physicians are responding by stepping up telehealth services, video visits, mental health screenings, and other innovations that are keeping them in tune with young patients and changing preferences.
Maintaining flexibility, innovation, and readiness as staples, primary care practices that continue to grow will become better equipped to manage change. According to one source, “To successfully practice in the future, physicians will need a mix of relationship-oriented skills to connect with patients and colleagues, quantitative skills to interpret complex data, a strong foundation in prevention to deliver wellness-oriented care, and a robust understanding of business and economics of medicine to drive population health.”***
*Sources: B. Starfield, L. Shi, and J. Macinko, “Contribution of Primary Care to Health Systems and Health,” Milbank Quarterly, Sept. 2005 83(3):457–502; and S. J. Spann, “Report on Financing the New Model of Family Medicine,” Annals of Family Medicine, Dec. 2004 2(2 Suppl. 3):S1–S21; https://www.primarycareprogress.org/primary-care-case/