Primary care needs to be the backbone of any healthcare fix

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I have been a physician for 22 years now.

I have many colleagues all over the country who I have known for at least a decade either through training, or meetings or advocacy work. As a group I would call us patient advocates. We are the ones fighting for patient’s rights. I am watching all of us burn out in the current climate.

The enormous cost shifting that has occurred via high deductible plans mean that at the preventive visit (covered with no copay) many take advantage of having paid a small fortune monthly for their policy, so they bring in a whole host of medical issues that are not part of this routine physical.

{mosads}Not only can we not address these issues properly during this preventive visit, but frankly our time is worth something.


I do not blame patients — with deductibles of several thousand dollars on top of high monthly policy costs they are trying to get something for what they are paying.

What patients fail to realize is that we cannot bill for those problems and the preventive visit. Nor is the time allotment appropriate for visits with “complaints.”

The system is that broken.

I replied to a colleague who was lamenting about this problem in a private group how much I wish I could just have Direct Primary Care for all my patients and not have to deal with all this nonsense but like these other physicians I am committed to taking Medicare and Medicaid as I believe in a social safety net.

We are all so sick of the billing codes, the prior authorizations that eat up so much of our day — this is not why we went to medical school. This is not why we had so many sleepless nights in training — our decisions should be the ones that matter not the peon at the insurance company looking at a decision template.

The demoralization is taking its toll.

These physicians are quitting.

They are fed up.

Brilliant minds that just cannot take it anymore.

The healthcare crisis is not just in whether the Affordable Care Act is the right way to continue, but our failure to recognize the value in primary care offered by family medicine physicians.

We already have a shortage in primary care. This is not replaceable by mid-levels, apps or websites.

I see firsthand daily what my additional training brings when patients come in frustrated that their previous caregiver could not figure out what was going on — something simple to a physician may not be to a physician assistant or family nurse practitioner.

The healthcare overhaul needs to give physicians the reigns. Insurance companies and legislators do not have the training we have and should not be making the decisions. Patients suffer and so do physicians.

A bipartisan initiative needs to include stakeholders but make no mistake — physicians need to take medicine back. We need to go back to the days of a patient physician contract without intrusion.

Patients over politics.

Dr. Cathleen London is physician based in Maine who developed a cost-effective alternative to the standard EpiPen in response to skyrocketing prices. London has been an on-air contributor on Fox News and local television stations around the nation. Her healthcare innovations have been featured in the New York Times.

The views expressed by contributors are their own and are not the views of The Hill.

Tags Affordable Care Direct primary care doctors Family medicine Healthcare reform ObamaCare TrumpCare

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