The role of the primary care physician in American healthcare has been dwindling in the past few years. This seems to be a purely American concept, as the trend is not showing elsewhere. Why is this? What is the primary care physician’s role in post hospital care? And how can the trend be reversed?
Fewer primary care physicians
Despite evidence establishing the importance of primary care physicians, the number of primary care physicians in the US has declined. One study showed that currently, specialists make up 60% of the nations doctors, even though they are seeing fewer patients. This is due to a number of snowballing factors, beginning with how third-party insurance works. In our third party insurance system, new advances in technology and procedures get higher payments. And these newer technological advances are usually relevant to specialists, or even subspecialists, who make a practice out of these niche procedures and get paid very well. In fact, regular well care visits and preventative care often don’t get paid at all. Specialist also usually have fewer and more predictable work hours and often have a higher standing in the medical system. Medical students are heading in droves toward specialties and subspecialties, and there are fewer primary care physicians available to treat patients.
In socialized healthcare, this disparity doesn’t play out so severely, so this is a distinctly American issue.
What is the importance of the primary care physician?
The primary care physician has been shown, through much literature, to be a crucial element of an effective healthcare system. The primary care physician, or pcp, is responsible for seeing the whole picture of the patient’s well-being and making recommendations to stay healthy or to treat disease.
Studies show that stronger primary care structures have better national health, lower mortality rates, higher birth weights, and more satisfaction with the medical system. One US study showed that more pcp availability in an area showed better health outcomes and less use of expensive healthcare procedures and hospitalization.
PCPs and post hospital care
If there is a strong relationship between the patient and his pcp, there are more benefits for his post hospital care. When the patient leaves the hospital, he often needs direction to maintain his health and not relapse and require rehospitalization. Someone needs to manage his health and help him stay on the right path. One study showed that active pcp communication with a patient within 24 hours of his release from a hospital resulted in fewer mistakes in medication. The pcp is a neutral party when it comes to choosing a post hospital care facility, such as the Alameda Center, that’s best for the patient. And if the patient continues to have regular communication with his pcp after release, his odds of staying out of the hospital increase.
This is a problem in the American healthcare system that needs to be better addressed.