The ACP Advocate Blog
by Bob Doherty
Wednesday, May 20, 2009
"This is the start of making primary care cool again"
So says Dr. Ari Silver-Isenstadt, a young pediatrician associated with the National Physicians Alliance. He was one of a broad spectrum of organizations - representing physicians, nurses, nurse-practitioners, and medical colleges - that joined today with Rep. Schwartz to announce support for the Preserving Patient Access to Primary Care of 2009, H.R. 2350.
"It is critical that comprehensive reforms to halt the crisis in access to primary care be included in any legislation to expand health insurance coverage," said ACP President Joseph W. Stubbs, in announcing the ACP's support for the bill. "Providing everyone with affordable coverage is essential, but coverage alone doesn't guarantee access if there aren't enough primary care physicians to take care of patients. And without primary care, the costs of covering everyone will be much higher and the outcomes much poorer."
Earlier in the day, Rep. Schwartz spoke to the 400 plus attendees of ACP's Leadership Day on Capitol Hill about her efforts to support primary care. She noted that the bill already has the support of nearly 100 members of Congress, and she asked for ACP's help in lining up more supporters. We also learned that within days, Senator Maria Cantwell (D-WA) will be introducing the bill in the U.S. Senate.
Would the Preserving Patient Access to Primary Care Act really make primary care cool again? My teenage girls would tell you I am the last person to know what's cool, but I think it would be cool if the U.S. Congress officially declared that primary care is essential to a better performing health care system.
It would be cool if Medicare started paying primary care doctors more, and giving them credit for helping to keep people out of the hospital. It would be cool if medical students who go into primary care could graduate without debt. It would be cool if primary care physicians could be compensated for providing patient-centered care through a medical home. It would be cool to reduce the cost barriers to preventive services. And how cool would it be to reduce the paperwork hassles associated with Medicare drug formularies and claims adjudication?
All these, and more, are included in the Preserving Patient Access to Primary Care Act of 2009.
I know that some will not agree with me on this, but I also think it is cool that the Preserving Patient Access to Primary Care Act has the support of both doctors and nurses. Rep. Schwartz believes (and the evidence supports this) that the United States needs more primary care internists, family physicians and pediatricians, and also needs more nurse-practitioners and physician assistants.
I fully understand that primary care physicians and NPs don't always see eye-to-eye on each one's respective roles in primary care or in the medical home. But as I have written about on other occasions, a political split between NPs and primary care physicians could be fatal to getting meaningful primary care legislation enacted. Wouldn't this be the most un-cool outcome of all for the patients who desperately need access to primary care?
Today's question: What do you think needs to be done to make primary care cool (again)?
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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