The ACP Advocate Blog
by Bob Doherty
Monday, December 15, 2008
Primary care has no value?
So says Dr. Jonathan Glauser, an emergency physician and MBA. Writing in Emergency Medical News about proposals to increase funding for primary care, Dr. Glauser had this to say:
"To fund such a venture for groups that are singularly inept at performing anything of value to society is pure folly and a waste of precious health care dollars."
Oh, there's more. "How could we as physicians ever allow a doctor to call himself primary care when he can't manage simple chronic illness; cannot definitively treat acute illness or injury; often has no skills to save lives and no access to equipment if he had the skills; and does not even see patients at their own (the customers') convenience?"
And this: "Their unparalleled record of failure and complete dispensability does not merit even a second thought of throwing dollars their way."
Complete dispensability and no value to society? To put it as kindly as I can, it appears that Dr. Glauser didn't do his homework.
If he had, he would have known about the hundred-plus studies, annotated by ACP, which show that primary care is consistently associated with better outcomes and lower cost of care.
He would have known from our review that "states with higher ratios of primary care physicians to population have better health outcomes, including decreased mortality from cancer, heart disease, or stroke; individuals living in states with a higher ratio of primary care physicians to population are more likely to report good health than those living in states with a lower ratio; and the supply of primary care physicians is also associated with an increase in life span."
He would have known that "an increase of just one primary care physician per 100,000 population reduces ER visits by 10.9 percent."
The ranting of one emergency room doctor might not be worthy of comment, except I wonder how many other ER physicians share his distorted and uninformed view of primary care.
ACP plans to send a response to Emergency Medical News. You can help us by posting a response to today's blog. The most interesting comments are likely to be quoted (with your permission) by ACP.
Today's question: How would you respond to Glauser's view that primary care (and by implication, general internal medicine) is "singularly inept at performing anything of value to society, is pure folly and a waste of precious health care dollars?"
About the Author
Bob Doherty is Senior Vice President, American College of Physicians Government Affairs and Public Policy; Author of the ACP Advocate Blog
Email Bob Doherty: TheACPAdvocateblog@acponline.org.Follow @BobDohertyACP
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