Solving the Crisis in Healthcare Means Solving the Crisis in Primary Care
In this deeply researched yet controversial book, Stephen C. Schimpff, MD breaks definitive new ground to explain why our healthcare delivery system serves us so poorly, why it costs so much, and why government and insurer policy over many decades has not only failed to improve care delivery but actually has made it worse. The fundamental problem is a crisis in primary care. Primary care physicians are forced into a non-sustainable business model that drives them to schedule an unreasonable number of patient visits per day because insurance-based payment is too low. In inflation adjusted dollars, PCPs earn about the same now as they did thirty years ago but see about twice as many patients per day to do so. Too many visits means not enough time per patient. Not enough time means it is easier to just refer a patient to a specialist, or a test or write a prescription when some more time would have resulted in a solution to the problem and saved the need and cost of specialist, tests and medication. This has led to a diminishment of care quality and a major increase in costs.
When primary care physicians do have time with each patient, they can offer truly outstanding care for episodic issues, effectively address complex chronic illnesses (which consume 75-85% of all medical care costs), and provide effective preventive care while maintaining health and wellness - and do so within a deep personal relationship of trust and healing. Paradoxically, primary care need not be expensive. Insurance has made it so. The time has come to break the bond between insurance and primary care and allow the primary care physician the ability to care at his or her highest level of professional education, training and competency. The result will be better care at less cost-he major theme of this book. Through interviews with more than 40 primary care physicians, along with extensive research, I will show how to put healthcare back in the hands of patients and their physicians.
If we want to see better and more affordable healthcare in this country, the changes discussed in this book must be implemented. The result will be very different medical care delivery - it will become true healthcare - much better and much less costly.
This book provides the needed information, the methodology and the roadmap to achieve world class healthcare delivery at a reasonable cost.
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