Comments on: Commentary: Why primary care doctors are fed up – CNN.com http://rmfo-blogs.com/philber/2009/08/25/commentary-why-primary-care-doctors-are-fed-up-cnn-com/ Much of what we do is both frightfully profound and mundane, with a thin line between life and death. Sat, 22 May 2010 05:27:11 +0000 hourly 1 http://wordpress.org/?v=3.5.1 By: philber http://rmfo-blogs.com/philber/2009/08/25/commentary-why-primary-care-doctors-are-fed-up-cnn-com/comment-page-1/#comment-2768 philber Fri, 28 Aug 2009 03:12:52 +0000 http://rmfo-blogs.com/philber/?p=751#comment-2768 I think opening primary care up more to mid-levels is a very good and under-implemented idea, especially when put together in a practice with full-fledged MDs (of course, this all depends on the state you’re in). I am not such a big fan of “doc in the box” urgent care clinics without actual docs, as it’s not truly primary care/medical home and lacking a full-fledged MD. I know I am biased in this, because there are just things that come with more in-depth training that many mid-level providers do not have until well into their career.

They do tend to be less debt-burdened, so they’re less likely to be looking for the money, although I have to say that in my experience, from a systems cost perspective, they’re just as inclined to order unnecessary tests because they’re less likely to be up-to-date on current guidelines/evidence base, since their training usually doesn’t emphasize this as much.

The hard part is how to ask patients to “take responsibility” for their primary care – do you ask them to pay more per PCP visit? Or less? How does that get people into see their PCP? How does it deter them?

]]> By: Valerie http://rmfo-blogs.com/philber/2009/08/25/commentary-why-primary-care-doctors-are-fed-up-cnn-com/comment-page-1/#comment-2767 Valerie Fri, 28 Aug 2009 00:45:19 +0000 http://rmfo-blogs.com/philber/?p=751#comment-2767 What about leaving much of primary care to nurse practitioners? Or opening more of primary care to nurse practitioners? They are well trained and able to do much of what PCPs can do, and can take some of the strain off the system. Additionally, because they tend to be less debt burdened, they might not need the money incentives that doctors might.

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