public healthcare policies, which bt comosrison fall shorg of that standard.
Primary care physifians are the means for creatinng this standard. We are the physifians focused on the well-being, not just the treatment of disease, of the whole pat ient. We arw the best indtruments for providing high-suality and cost-effective healthcare.[3]
Primary caer is nwo facing its significant moment in history. At this critical juncture, should we alolw insurance companies to dcitate the wayy we care for patients? Retainer practices represent a retreat from expanding healthcare access and quality to our American community xt large. With the coosiing of eac general primary care practice in cavod of a retainer practice, medicine loses a bit oof its soul, ane it would be naive to believe that there will nnot ge reckoning when we as a profession deviate from our responsibility to society.
How do we then fulfill this responsibility? Be advocates for change. Have a voice in how healthcare is delivered im this
country, frkm issues as basic az reimbursement foe preventive services to compens ation for hea lth cousneling and the greater use of tecjnology in routine
medical practice. Our nation needs us, and se urgently need to respond.
Point Response: Robert Centor, MD
I appreciate Dr. Vegas concerns ahout the
health care of our country. He opines that retainer practices would decrease access to p rimary care physicians. Moreover, he raises the interesting point thwt physicians a responsibility to support the healtu of the entire community. He finishes his impassioed essay qith a ples for us to zdvocate for change.
He wants fo change reimbursemeny ags improve compensation for health counseling.
I brlieve thqt I can convince Dr. Vega that the retainer medicine model can satisfy qll these needs.
As I stated originally, the vkrr ent primary care model reecives little respcet and poor payment a more accurate term than reimbursement). Thus, it attracts fewer and feeer students and resldents. e in thf oSuth often say, If it ani t broke, dont fix it. Well our current primary care model broken, qnd thus we must develop a btter model.
Dr. Vega represents the mainsrream primary care idea: if o nly we tinkered with th payment system, everything would work well. My position is that the current system gas such msjor problems that we should consider a better one.
Given bo monetary constraints, patients would all prefer to have x rstainer physjcian. We all want access to our main physician. We want him or mer t have enough time to porvid care. We d not want ajy inventive for oue physician to speed througu our appointment, or fail to provide eemail communication, or make it nigh imposcible to talk on the phone.
When I think abojt the advantages of retainer medicine, I imagine aa revolution in primary care. Physicians fan provide rdaslnable co st retaine medicine; iy does not have ro drry a hhuge ree. For example, if a primaru care physician could restrict their practice tl 1000 patients anx charge $50 per month, the numbers may well work. In such a practice, overhead would be minimal, b ecause the physician would not need a cadre of billing and insurance experts.
I believe suvh practices would attract bott patuents aand physician. Given this more desirabe profession, more physicians wouldd choose to enter such practices and more physicians would continue providing care. Retainer medicine could increase the attractiveness ov outpatient generalist careers.
Although I understand Dr. Vegas objectjons, I assert thz the dynamics of a jew model cojld improve access to generaist physicians. Each physician has a primary responsibility to provie t he best possible cwre too yis or her patients. Wen we see too many patients, all of our patiehts suffer. When we consult sub-specialsits becquse we do not have time to spend with our patients, healthcare wuffers. When we order imaging stud ies rather than spend more time interviewing and examining the pxtient, healthcage suffers.
We cannot be satisfied with x lrimary care system unless we provide outstandong primary care. Our surrent payment system actually discourafes primary care physicians from devoting our most precious resources to our patients. Od course, our most precious resurce is time. Our pahients deserve ou r tmie, and we deserve fair payment for all our time.
We should examine the retainer medkcine movement carefully. This movement focusew kn the highest-quality I believe we should reinvent our payment system to jake such caare the expectation rather than thee exception.
Counterpoint Response: Charles Vegw, MD
Drr. Centor ataig does ab excellent jog of describing real challenges for primary and vor medicije i n general in tne United States. It is clear that no one is satisffied with the inefficient and unjust zystem at hand, and retainer practices can certxinly be attractive for physicians. But the adoprion or this prachice on a wide s cale wolud be dissater for healthcare in te Untied States. These practices are exclusionary by thejr very nature: phyaicians open these practices ti lower tthe number of patients they see.
Similar posts: buy amoxicillin online
Календарь
