While public health advocates are mobilizing to thwart the anti-vaxxer's confirmation, his acolytes want to revamp physician pay to boost primary care. It's long overdue.
PCPs in other countries serve as gatekeepers to the consultants (specialists) and are better paid for their management of patients. The results are obvious every two years when the Commonwealth Fund compares the results across high-income countries. Since the comparisons began in 2004, the US has consistently ranked last.
It's time for the dinosaurs at the AMA to be replaced by an independent body that understands that illness prevention, chronic care management and dealing with the social determinants of health are key to Americans achieving the 4-5 year higher life expectancies of other high-income countries.
Also the politically more powerful and wealthier specialty societies. See Swenson, House of Medicine for Rent, in Medscape. Like AMA, on the take from big Pharma.
It is time for value-based compensation to replace the time-and-materials payment model like car mechanics. Primary care is also much more than gatekeepers to specialty care: they are managers, coordinating and orchestrating. That takes time that has no Relative Value Unit, but requires compensation if we want PCPs to truly manage cases and not just refer them on to higher paid specialists.
There is value in avoiding hospitalization and ER visits because preventive care and monitoring has been rendered. There is value in avoiding rebound hospitalizations and ER visits because post-discharge follow-up takes place in a timely manner. Tracking and focusing on medication adherence is another valuable primary care task. Can we agree that PCPs must be compensated for their time and expertise beyond transactional office visits?
Merrill nails it again!
PCPs in other countries serve as gatekeepers to the consultants (specialists) and are better paid for their management of patients. The results are obvious every two years when the Commonwealth Fund compares the results across high-income countries. Since the comparisons began in 2004, the US has consistently ranked last.
It's time for the dinosaurs at the AMA to be replaced by an independent body that understands that illness prevention, chronic care management and dealing with the social determinants of health are key to Americans achieving the 4-5 year higher life expectancies of other high-income countries.
Also the politically more powerful and wealthier specialty societies. See Swenson, House of Medicine for Rent, in Medscape. Like AMA, on the take from big Pharma.
It is time for value-based compensation to replace the time-and-materials payment model like car mechanics. Primary care is also much more than gatekeepers to specialty care: they are managers, coordinating and orchestrating. That takes time that has no Relative Value Unit, but requires compensation if we want PCPs to truly manage cases and not just refer them on to higher paid specialists.
There is value in avoiding hospitalization and ER visits because preventive care and monitoring has been rendered. There is value in avoiding rebound hospitalizations and ER visits because post-discharge follow-up takes place in a timely manner. Tracking and focusing on medication adherence is another valuable primary care task. Can we agree that PCPs must be compensated for their time and expertise beyond transactional office visits?
Even a broken clock is right twice a day