The best and brightest PCP worry worts dream of fixes made of fairy dust. ( Sigh)
Here’s their Big Fix:
- 1) The Committee that sets pay for PCPs (the RUC)is too dominated by specialists. True! Reality:It’s also powerless since 2009( Obamacare) -its suggestions are ignored by CMS ( the feds who price all the coding)because they are overwhelmed. A “new” PCP powered replacement will never happen. Power. And if it did it would too be ignored. So fix the RUC? It’s a joke.
- Funds should be reallocated from residencies for specialists into primary care residencies. True but… – Another pipe dream. PCPs are going into the octagon against specialists AND teaching hospitals? Ok. Place your bets.
- Direct Primary Care is a yummy solution.
But only for docs in great zip codes and the 10% +\- who can afford $150 / mo. It sucks for the 85-90% they abandon. And they do.
This accelerates shortages. Burnout. Undeniably. Stop using DPC as the fix it fixes primary care docs, not the patients. It looks awful selfish to 90% of Americans.
The Answer:
First ask The Q: Is the model itself a hot mess?Bump pay with fairy dust and you are stuck with a model which rewards volume not quality.
Ancillary services add:
- patient value and loyalty
- compliance
- adherence to meds
- relaxed unhurried exams… Really??
And saves primary care with a single decision of the doc. No reforms. Just elbow grease.
