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I have received lots of notes from readers about other pet peeves they have about practicing primary care in our current environment and wanted to share some of them. I appreciate all the emails I received on this topic.
- The rapid increase in the number of hospital administrators in the last 50 years
This has increased health system costs without providing any relief for practicing physicians, and often has led to policies that have been harmful and detrimental. This would be a great place to start cutting back to get true savings without affecting quality of care.
- Emergency physicians and specialists who refer my patient elsewhere for a service we provide in our office
It is expensive for patients to go to a specialty provider for a simple procedure that can be easily done in a primary care practice, or to be referred to see a specialist for a problem that does not need specialty care. This creates further problems accessing specialists.
- Online reviews of practices, including reviews from people who have never been patients
I am concerned about the accuracy and intent of online reviews. If a patient is upset because they did not receive an antibiotic or narcotic, they can vent their frustration in a review, when what the medical professional was actually doing was good medicine. More concerning to me is that some organizations use these reviews to determine compensation, promotion, and support. These reviews are not evidence based or accurately collected.
- Offices and organizations being dropped by insurance carriers
Insurance companies are running amok. They make their own rules, which can devastate practices and patients. They can change fees paid unilaterally, and drop practices without explanation or valid reasons. Patients suffer terribly because they now cannot see their long-time physicians or they have to pay much more to see them as they are suddenly “out of network.”
- The lack of appreciation by organizations as well as the general public of the enormous cost savings primary care professionals contribute to the healthcare system
There are many studies showing that patients who see a primary care physician save the system money and have better health outcomes. US adults who regularly see a primary care physician have 33% lower healthcare costs and 19% lower odds of dying prematurely than those who see only a specialist.1
In one study, for every $1 invested in primary care, there was $13 in savings in healthcare costs.2 I had a patient a few years ago complain about the “enormous” bill she received for a visit where I had done an annual exam, cryotherapy for three actinic keratoses, and a steroid injection for her ailing knee. The cost savings was well over $700 (the new patient cost for two specialty visits). There is no doubt that patients who have stable primary care save money themselves and for the whole medical system.
- The stress of being witness to a dysfunctional system
It is really hard to see the hurt and difficulty our patients go through on a daily basis while trying to navigate a broken system. We bear witness to them and listen to all the stories when things have gone wrong. This also takes its toll on us, as we are part of the system, and our patients’ frustrations sometimes boil over. We are also the ones who care for the whole patient, so every bad experience with a specialty clinic is shared with us.
Many thanks extended to those who wrote to share their ideas (Drs. Sylvia Androne, Bhawna Bahethi, Pierre Ghassibi, Richard Katz, Louis Kasunic, Rebecca Keenan, David Kosnosky, Gregory Miller, and James Wilkens).
Dr. Paauw is professor of medicine in the Division of General Internal Medicine at the University of Washington, Seattle, and he serves as third-year medical student clerkship director at the University of Washington, Seattle. Contact Dr. Paauw at dpaauw@uw.edu.
References
1. Forbes.com. Why Primary Care Matters, and What We Can Do To Increase It. 2023 Nov 27.
2. Washingtonpost.com. A Health Care Solution We Can’t Afford to Ignore: Primary Care.
I have received lots of notes from readers about other pet peeves they have about practicing primary care in our current environment and wanted to share some of them. I appreciate all the emails I received on this topic.
- The rapid increase in the number of hospital administrators in the last 50 years
This has increased health system costs without providing any relief for practicing physicians, and often has led to policies that have been harmful and detrimental. This would be a great place to start cutting back to get true savings without affecting quality of care.
- Emergency physicians and specialists who refer my patient elsewhere for a service we provide in our office
It is expensive for patients to go to a specialty provider for a simple procedure that can be easily done in a primary care practice, or to be referred to see a specialist for a problem that does not need specialty care. This creates further problems accessing specialists.
- Online reviews of practices, including reviews from people who have never been patients
I am concerned about the accuracy and intent of online reviews. If a patient is upset because they did not receive an antibiotic or narcotic, they can vent their frustration in a review, when what the medical professional was actually doing was good medicine. More concerning to me is that some organizations use these reviews to determine compensation, promotion, and support. These reviews are not evidence based or accurately collected.
- Offices and organizations being dropped by insurance carriers
Insurance companies are running amok. They make their own rules, which can devastate practices and patients. They can change fees paid unilaterally, and drop practices without explanation or valid reasons. Patients suffer terribly because they now cannot see their long-time physicians or they have to pay much more to see them as they are suddenly “out of network.”
- The lack of appreciation by organizations as well as the general public of the enormous cost savings primary care professionals contribute to the healthcare system
There are many studies showing that patients who see a primary care physician save the system money and have better health outcomes. US adults who regularly see a primary care physician have 33% lower healthcare costs and 19% lower odds of dying prematurely than those who see only a specialist.1
In one study, for every $1 invested in primary care, there was $13 in savings in healthcare costs.2 I had a patient a few years ago complain about the “enormous” bill she received for a visit where I had done an annual exam, cryotherapy for three actinic keratoses, and a steroid injection for her ailing knee. The cost savings was well over $700 (the new patient cost for two specialty visits). There is no doubt that patients who have stable primary care save money themselves and for the whole medical system.
- The stress of being witness to a dysfunctional system
It is really hard to see the hurt and difficulty our patients go through on a daily basis while trying to navigate a broken system. We bear witness to them and listen to all the stories when things have gone wrong. This also takes its toll on us, as we are part of the system, and our patients’ frustrations sometimes boil over. We are also the ones who care for the whole patient, so every bad experience with a specialty clinic is shared with us.
Many thanks extended to those who wrote to share their ideas (Drs. Sylvia Androne, Bhawna Bahethi, Pierre Ghassibi, Richard Katz, Louis Kasunic, Rebecca Keenan, David Kosnosky, Gregory Miller, and James Wilkens).
Dr. Paauw is professor of medicine in the Division of General Internal Medicine at the University of Washington, Seattle, and he serves as third-year medical student clerkship director at the University of Washington, Seattle. Contact Dr. Paauw at dpaauw@uw.edu.
References
1. Forbes.com. Why Primary Care Matters, and What We Can Do To Increase It. 2023 Nov 27.
2. Washingtonpost.com. A Health Care Solution We Can’t Afford to Ignore: Primary Care.
I have received lots of notes from readers about other pet peeves they have about practicing primary care in our current environment and wanted to share some of them. I appreciate all the emails I received on this topic.
- The rapid increase in the number of hospital administrators in the last 50 years
This has increased health system costs without providing any relief for practicing physicians, and often has led to policies that have been harmful and detrimental. This would be a great place to start cutting back to get true savings without affecting quality of care.
- Emergency physicians and specialists who refer my patient elsewhere for a service we provide in our office
It is expensive for patients to go to a specialty provider for a simple procedure that can be easily done in a primary care practice, or to be referred to see a specialist for a problem that does not need specialty care. This creates further problems accessing specialists.
- Online reviews of practices, including reviews from people who have never been patients
I am concerned about the accuracy and intent of online reviews. If a patient is upset because they did not receive an antibiotic or narcotic, they can vent their frustration in a review, when what the medical professional was actually doing was good medicine. More concerning to me is that some organizations use these reviews to determine compensation, promotion, and support. These reviews are not evidence based or accurately collected.
- Offices and organizations being dropped by insurance carriers
Insurance companies are running amok. They make their own rules, which can devastate practices and patients. They can change fees paid unilaterally, and drop practices without explanation or valid reasons. Patients suffer terribly because they now cannot see their long-time physicians or they have to pay much more to see them as they are suddenly “out of network.”
- The lack of appreciation by organizations as well as the general public of the enormous cost savings primary care professionals contribute to the healthcare system
There are many studies showing that patients who see a primary care physician save the system money and have better health outcomes. US adults who regularly see a primary care physician have 33% lower healthcare costs and 19% lower odds of dying prematurely than those who see only a specialist.1
In one study, for every $1 invested in primary care, there was $13 in savings in healthcare costs.2 I had a patient a few years ago complain about the “enormous” bill she received for a visit where I had done an annual exam, cryotherapy for three actinic keratoses, and a steroid injection for her ailing knee. The cost savings was well over $700 (the new patient cost for two specialty visits). There is no doubt that patients who have stable primary care save money themselves and for the whole medical system.
- The stress of being witness to a dysfunctional system
It is really hard to see the hurt and difficulty our patients go through on a daily basis while trying to navigate a broken system. We bear witness to them and listen to all the stories when things have gone wrong. This also takes its toll on us, as we are part of the system, and our patients’ frustrations sometimes boil over. We are also the ones who care for the whole patient, so every bad experience with a specialty clinic is shared with us.
Many thanks extended to those who wrote to share their ideas (Drs. Sylvia Androne, Bhawna Bahethi, Pierre Ghassibi, Richard Katz, Louis Kasunic, Rebecca Keenan, David Kosnosky, Gregory Miller, and James Wilkens).
Dr. Paauw is professor of medicine in the Division of General Internal Medicine at the University of Washington, Seattle, and he serves as third-year medical student clerkship director at the University of Washington, Seattle. Contact Dr. Paauw at dpaauw@uw.edu.
References
1. Forbes.com. Why Primary Care Matters, and What We Can Do To Increase It. 2023 Nov 27.
2. Washingtonpost.com. A Health Care Solution We Can’t Afford to Ignore: Primary Care.
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Paauw</byline> <bylineText/> <bylineFull/> <bylineTitleText/> <USOrGlobal/> <wireDocType/> <newsDocType/> <journalDocType/> <linkLabel/> <pageRange/> <citation/> <quizID/> <indexIssueDate/> <itemClass qcode="ninat:text"/> <provider qcode="provider:imng"> <name>IMNG Medical Media</name> <rightsInfo> <copyrightHolder> <name>Frontline Medical News</name> </copyrightHolder> <copyrightNotice>Copyright (c) 2015 Frontline Medical News, a Frontline Medical Communications Inc. company. All rights reserved. This material may not be published, broadcast, copied, or otherwise reproduced or distributed without the prior written permission of Frontline Medical Communications Inc.</copyrightNotice> </rightsInfo> </provider> <abstract/> <metaDescription>BY DOUGLAS S. PAAUW, MD</metaDescription> <articlePDF/> <teaserImage>248215</teaserImage> <teaser>Physicians note the increase in the number of hospital administrators, specialists who refer patients away from primary care, insurance carriers dropping practices, and more.</teaser> <title>Pet Peeves About the State of Primary Care – Part 2</title> <deck/> <disclaimer/> <AuthorList/> <articleURL/> <doi/> <pubMedID/> <publishXMLStatus/> <publishXMLVersion>1</publishXMLVersion> <useEISSN>0</useEISSN> <urgency/> <pubPubdateYear/> <pubPubdateMonth/> <pubPubdateDay/> <pubVolume/> <pubNumber/> <wireChannels/> <primaryCMSID/> <CMSIDs/> <keywords/> <seeAlsos/> <publications_g> <publicationData> <publicationCode>fp</publicationCode> <pubIssueName/> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> </publicationData> <publicationData> <publicationCode>im</publicationCode> <pubIssueName/> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> </publicationData> </publications_g> <publications> <term>15</term> <term canonical="true">21</term> </publications> <sections> <term canonical="true">39786</term> </sections> <topics> <term canonical="true">38029</term> </topics> <links> <link> <itemClass qcode="ninat:picture"/> <altRep contenttype="image/jpeg">images/2400c6a0.jpg</altRep> <description role="drol:caption">Dr. Douglas S. Paauw</description> <description role="drol:credit"/> </link> </links> </header> <itemSet> <newsItem> <itemMeta> <itemRole>Main</itemRole> <itemClass>text</itemClass> <title>Pet Peeves About the State of Primary Care – Part 2</title> <deck/> </itemMeta> <itemContent> <p>BY DOUGLAS S. PAAUW, MD<br/><br/></p> <p>I have received lots of notes from readers about other pet peeves they have about practicing primary care in our current environment and wanted to share some of them. I appreciate all the emails I received on this topic.</p> <ul class="body"> <li><strong>The rapid increase in the number of hospital administrators in the last 50 years</strong> </li> </ul> <p>This has increased health system costs without providing any relief for practicing physicians, and often has led to policies that have been harmful and detrimental. This would be a great place to start cutting back to get true savings without affecting quality of care.[[{"fid":"248215","view_mode":"medstat_image_flush_right","fields":{"format":"medstat_image_flush_right","field_file_image_alt_text[und][0][value]":"Dr. Douglas S. Paauw, University of Washington, Seattle","field_file_image_credit[und][0][value]":"","field_file_image_caption[und][0][value]":"Dr. Douglas S. Paauw"},"type":"media","attributes":{"class":"media-element file-medstat_image_flush_right"}}]]</p> <ul class="body"> <li> <strong>Emergency physicians and specialists who refer my patient elsewhere for a service we provide in our office</strong> </li> </ul> <p>It is expensive for patients to go to a specialty provider for a simple procedure that can be easily done in a primary care practice, or to be referred to see a specialist for a problem that does not need specialty care. This creates further problems accessing specialists.</p> <ul class="body"> <li> <strong>Online reviews of practices, including reviews from people who have never been patients</strong> </li> </ul> <p>I am concerned about the accuracy and intent of online reviews. If a patient is upset because they did not receive an antibiotic or narcotic, they can vent their frustration in a review, when what the medical professional was actually doing was good medicine. More concerning to me is that some organizations use these reviews to determine compensation, promotion, and support. These reviews are not evidence based or accurately collected.</p> <ul class="body"> <li> <strong>Offices and organizations being dropped by insurance carriers</strong> </li> </ul> <p>Insurance companies are running amok. They make their own rules, which can devastate practices and patients. They can change fees paid unilaterally, and drop practices without explanation or valid reasons. Patients suffer terribly because they now cannot see their long-time physicians or they have to pay much more to see them as they are suddenly “out of network.”</p> <ul class="body"> <li> <strong>The lack of appreciation by organizations as well as the general public of the enormous cost savings primary care professionals contribute to the healthcare system</strong> </li> </ul> <p>There are many studies showing that patients who see a primary care physician save the system money and have better health outcomes. US adults who regularly see a primary care physician have 33% lower healthcare costs and 19% lower odds of dying prematurely than those who see only a specialist.<sup>1</sup> </p> <p>In one study, for every $1 invested in primary care, there was $13 in savings in healthcare costs.<sup>2</sup> I had a patient a few years ago complain about the “enormous” bill she received for a visit where I had done an annual exam, cryotherapy for three actinic keratoses, and a steroid injection for her ailing knee. The cost savings was well over $700 (the new patient cost for two specialty visits). There is no doubt that patients who have stable primary care save money themselves and for the whole medical system.<br/><br/></p> <ul class="body"> <li> <strong>The stress of being witness to a dysfunctional system</strong> </li> </ul> <p>It is really hard to see the hurt and difficulty our patients go through on a daily basis while trying to navigate a broken system. We bear witness to them and listen to all the stories when things have gone wrong. This also takes its toll on us, as we are part of the system, and our patients’ frustrations sometimes boil over. We are also the ones who care for the whole patient, so every bad experience with a specialty clinic is shared with us.</p> <p><br/><br/>Many thanks extended to those who wrote to share their ideas (Drs. Sylvia Androne, Bhawna Bahethi, Pierre Ghassibi, Richard Katz, Louis Kasunic, Rebecca Keenan, David Kosnosky, Gregory Miller, and James Wilkens).<span class="end"/></p> <p> <em>Dr. Paauw is professor of medicine in the Division of General Internal Medicine at the University of Washington, Seattle, and he serves as third-year medical student clerkship director at the University of Washington, Seattle. Contact Dr. Paauw at <span class="Hyperlink"><a href="mailto:dpaauw%40uw.edu?subject=">dpaauw@uw.edu</a></span>.<br/><br/></em> </p> <h2>References</h2> <p>1. <span class="Hyperlink"><a href="https://www.forbes.com/sites/forbesbooksauthors/2023/11/27/why-primary-care-matters-and-what-we-can-do-to-increase-it/?sh=29a192931b51">Forbes.com</a></span>. Why Primary Care Matters, and What We Can Do To Increase It. 2023 Nov 27.<br/><br/>2. <span class="Hyperlink"><a href="https://www.washingtonpost.com/sf/brand-connect/health-is-primary/a-healthcare-solution-we-cant-afford-to-ignore/">Washingtonpost.com</a></span>. A Health Care Solution We Can’t Afford to Ignore: Primary Care. </p> </itemContent> </newsItem> <newsItem> <itemMeta> <itemRole>teaser</itemRole> <itemClass>text</itemClass> <title/> <deck/> </itemMeta> <itemContent> </itemContent> </newsItem> </itemSet></root>
