Saturday, June 27, 2009

A remedy for health-care costs?

BusinessWeek has a very interesting article titled, "The family doctor: a remedy for health-care costs?" Will it ease the healthcare burden if we make primary-care physicians the center of America's health system? Perhaps the next question is, "what does it mean to make the PCP the center of the health system?"

This article starts with the line: "The primary-care doctor is gaining new respect in Washington." So many medical students have no interest in primary care. Are they not getting the right type of exposure to the world of primary care? Perhaps they are disillusioned and they don't fail to see the benefits of being a primary care provider (PCP).

Lately, there has been much talk about healthcare reform, electronic health records (EHRs), and the Patient-Centered Medical Home (PCMH). Can the medical home model actually save $67 billion a year? That reflects a 5.6% savings on healthcare costs. IBM's Director of Health-Care Transformation Dr. Paul H. Grundy led IBM to start the Patient-Centered Primary Care Collaborative. I think many people are curious to see how the medical home model will impact healthcare costs in these large corporations. If only 27% of physician practices qualify as a medical home, then what type of impact are we expecting to see?


  1. Dr Kim. You introduce a significant subject here---but I have no idea were your going with the issue. I personally like the PCP model. For several years my PCP, as my primary point of contact for family health care, has served me well in several locales in the US. My wife and I have always been able to build rapport--and feel comfortable with the care and advice we've received---to include referrals to specialists when appropriate. Is your point that people entering the medical profession are jaded by the promise of big bucks as specialists---or are they ill informed as to the value brought to individuals and families through a PCP model? And what are you proposing? In this post you've merely asked questions --- but offered no opinions or recommendations. Posing problem statements is easy---suggesting solutions is where value. is added

  2. The benefit of the Medical Home concept is that it it is more primary care centered than some of the more recent forms of primary care. The value of Medical Home primary care is that one primary care physician follows a patient rather than going to a primary care clinic and seeing who ever is available (Dr. A, Dr. B, PA C or ARNP D). There is improvement in the quality of care by having one physician that really knows the patient, including when a mid-level provider (PA or ARNP) happens to see a patient. In the Medical Home one physician has the primary relationship with the patient everything about the patient is reviewed by the one physician. Some clinics that are not a Medical Home no one in particular knows the patient or only the mid-level knows the patient. These forms of primary care clinics can be found in drug stores or attached to a medical center (like the hospital clinic on the show House). There is an advantage in knowing and treating the same patient over time.