Effective, comprehensive primary care is the foundation of high performing health systems. This multi-contributor blog addresses effective, comprehensive primary care and how we might create a policy environment that truly supports effective, comprehensive primary care.
IMP doc Marty Schulman is featured in this KPBS piece on concierge medicine.
The good news is that people are starting to recognize the value of practices that take the time to care for their patients. We haven't solved all the health problems of the US, but we're doing what we can to improve care and keep the hope of primary care alive.
I know some health policy folks will hear Dr. Steward say he's caring for 800 people and worry about exacerbation of the primary care shortage. These policy folks need to better understand the source of the shortage. The primary care shortage is due to the intolerable nature of primary care as a career choice. We don't solve the problem by forcing docs to work on a production mill basis, seeing patients as "billable visits" rather than as human beings.
These practices exemplify the caring and compassion that are the core of our profession. Too many of our colleagues are trapped in jobs that daily erode their ability to maintain compassion in the face of productivity targets.
The choice between "maintain primary care supply through high volume care" versus "deliver compassionate care to fewer people" is false. IMPs have changed the paradigm of care, focusing on compassion, relationship, and care. The choice rests with policy makers to support this type of care for all people.
The health care clinicians do not choose the financing paradigm that limits choice and rations care - that is the choice of our policy makers. It is time for new policy.
Real health reform should provide universal access to practices like this.