The ACP Advocate Blog
by Bob Doherty
Wednesday, December 17, 2008
If life insurers, automakers, banks, and stockbrokers can get stimulus money from Washington, why not primary care?
Much has been said about primary care being the keystone (as Senator Baucus so aptly described it in his white paper) of a high performing health care system.
Yet we also know that primary care is experiencing death by a thousand cuts. Established primary care practices are struggling to survive. Young physicians in droves are turning to higher paid specialties.
President-elect Obama seems to understand. During the campaign, he observed that "primary care providers and public health practitioners have and will continue to lead efforts to protect and promote the nation's health. Yet, the numbers of both are dwindling."
His comments are on the mark: two recent studies published by the Association of American Medical Colleges and Health Affairs project a shortage of about 44,000-46,000 primary care physicians for adults.
When I met with the Obama transition team a few weeks ago, one of his staffers closed with a question, "What could be done in an economic stimulus package to help the economy and lay the foundation for comprehensive health care reform?"
ACP's answer: provide economic assistance to internists and other primary care physicians.
In a letter delivered today to Senator Tom Daschle, Obama's pick for Secretary of Health and Human Services, ACP proposed that primary care physicians receive a 10% Medicare payment bonus for all approved charges paid by Medicare through 2010.
We also proposed creation of economic incentives, directed toward primary care physicians in smaller practices, to acquire specific health information technology applications to support care coordination in a Patient-Centered Medical Home.
The letter goes on to make the case that the loss of even one primary care practice in a community during these tough economic times will put thousands of patients in the impossible situation of trying to find a new primary care physician, when most of the surviving primary care practices already are at full capacity and unable to take on any new patients.
We know that even a 10% increase in Medicare payments for primary care will not bring primary care earnings up to the point where they are competitive with other specialties, given the wide gaps that currently exist. But it would help struggling primary care practices keep their doors open for the next 18 months. It would also send a signal to medical students and residents that the new administration and Congress are committed to taking an important first step to making primary care an attractive and competitive career choice.
Today's questions: Do you agree that primary care should receive economic stimulus dollars? And how much more do you think primary care would need to be paid to be a competitive career choice?
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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