Aug 25 2009
A well-written piece. No matter how you cut it, people will follow the money and lifestyle. Until primary care is reimbursed at a reasonable amount compared to your gastroenterologist or anesthesiologist or otolaryngologist, people aren’t going to do it in the numbers truly needed for a good primary care foundation.
That means revamping the reimbursement scheme – don’t pay so much for procedures, and so little for counseling. Limit PCP legal liability. Even procedure-based subspecialists would like to do fewer procedures at times (heard the words straight out of their mouths just last month), since procedures still have risks. They tell the patient they don’t need the procedure, and the patient gets upset, and finds somebody out there who will indulge the patient and do an invasive procedure, driving up costs to the system. At the same time, doing the procedure is “safer” in terms of covering the MD legally, since they can at least say, “Look, here’s the cath/path/pictures to prove there was nothing wrong” when there was no medical indication to do the procedure/imaging in the first place (again, see the above article).
Those 2 simple, yet difficult, changes would make a world of difference.