Our differences are
driving us to distraction. Pick a television network, any network, and expect
to hear why we cannot agree on anything. Our political affiliations result in
conflict. The timing of our immigration to America divides us. (Because with
the exception of Native Americans, we are all immigrants.) Whether we shoot
guns or don’t divides us. The options for differences are endless.
In reality, our similarities
far outweigh our differences. Look down at your feet, consider your knees, work
your way up and consider your whole host of internal organs. Consider your arms,
and face, and top it all off with that brain in your head. Yep, we all have
physical bodies that need maintenance and assistance. Our lungs get congested, our
knees wear out, we need injections, and we break arms or toes.
Maybe you get your
healthcare at a community health center. Maybe you have a family medicine physician
who has treated you for your entire life. Maybe you periodically run to the
urgent care center and don’t even affiliate with any physician.
Regardless of our
differences, we all need primary care.
This Primary Care Week,
instead of an endless debate about the Affordable Care Act (ACA) and its
future, we need to ask ourselves the real questions.
·
How do we encourage young doctors to choose
primary care?
·
How do we change compensation to allow the
primary care physician (PCP) to earn a salary commiserate to their rich and
varied practices and skill sets?
·
How do we reduce the debt physicians incur to
enter a profession that limits their earning ability?
·
Where do advanced practitioners fit into the
delivery chain?
·
How do we deliver healthcare to the most
underserved?
·
How do we improve our support of the primary
care provider and the organizations that deliver this care?
·
How do we increase the number of residency slots
available for candidates?
·
How do we ensure that community health care
centers can continue to serve their communities?
The Obama Administration
did the ACA a huge disservice when they allowed the entire debate to revolve
around the insurance mandate. The ACA was a comprehensive approach to the
delivery of care to patients when and where they need it. Prior to ACA we had
universal health care. It was called the emergency room. We can’t go back.
Do many Americans know
that the ACA significantly changed the way that care is delivered to the
underserved? No! Do they know that CMMS and National Institutes of Health are
piloting new ways to compensate physicians? No! Do they know that the community
health care system delivers care to the underserved in a far more efficient and
effective manner than ever before? No! Do they know about the growth in urgent
care and its place in the delivery channel? No! Do they realize that technology
allows for care to be delivered in places previously unserved? No!
Tragically, the Centers
for Medicare and Medicaid Services have already announced that they are
cancelling three of the new reimbursement bundling programs intended to begin
in 2018. Unfortunately, most of our opinions and knowledge are based on what
political party we affiliate with and which agenda is driving the narrative. Political
narrative appears to already be impacting good programs that would change the
reimbursement models being tested.
This Primary Care Week, regardless of your political affiliation demand
that your elected officials address the real issues. We don’t have enough
providers and we don’t compensate them appropriately. We lack residency program
slots to educate physicians. We restrict the flow of foreign medical graduates which
further limit care to the underserved.
Primary care affects you.
If you don’t think so, just wait until the next time you get the flu or your
aging diabetic mom can’t get in to see a PCP because they don’t take Medicare.
Or perhaps you will retire to a beautiful community in the mountains of
Colorado only to find that no physicians are taking new patients with Medicare.
We can focus on our
similarities and make a real difference, but not unless we stand up to be
heard.
See Part II on the role
of physicians in this issue.
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