Major System Reforms Needed To Improve The State Of Primary Care Medicine In The US, ACP Says

Main Category: Primary Care / General Practice
Also Included In: Medical Students / Training
Article Date: 19 May 2008 - 4:00 PDT

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Declaring that "Primary care medicine is in a precipitous decline," David C. Dale, MD, FACP, president of the American College of Physicians (ACP), has joined with leading representatives of employers and consumers to issue a call for comprehensive reforms to attract, recruit and retain general internists and other primary care physicians.

During a panel discussion of the state of primary care medicine in the U.S., Dr. Dale and other panelists spoke about the challenges facing primary care and potential solutions.

"Despite the important role that a primary care physician plays in the health care system, it is increasingly becoming a 'fall back' option and not a true career choice among medical students," continued Dr. Dale.

Other panelists were Paul Grundy, MD, IBM director of health care, technology and strategic planning; Debra Ness, president of the National Partnership for Women and Families; Helen Darling, president of the National Business Group on Health; Yul D. Ejnes, MD, FACP, incoming chair of ACP's Medical Services Committee; and Ryan D. Mire, MD, FACP, a member of ACP's Council of Young Physicians.

"We believe we have to radically transform the payment system," Darling pointed out.

The panelists agreed that major reforms are needed to improve the state of primary care and the U.S. health care system overall. One of the ways proposed was through the patient-centered medical home (PCMH). The PCMH is a team-based model of care led by a personal physician who provides continuous and coordinated care throughout a patient's lifetime.

Dr. Ejnes noted that much of his time is not spent caring for patients, but instead "creating order out of chaos," as he coordinates care for patients.

The panelists agreed that physician payment policies by Medicare and other insurers need to be fundamentally restructured to pay primary care physicians for the time spent coordinating care for their patients, not just face-to-face encounters and to support the patient-centered medical home model. They also called for policies to reduce student loan debt for physicians who agree to train and practice in primary care fields.

Ness emphasized that it is critically important that that reforms of payment and delivery systems truly center on patients' needs. Dr. Grundy and Darling discussed the importance that businesses place primary care's role in improving outcomes and lowering costs for their employees.

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Article adapted by Medical News Today from original press release.
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ACP and the other groups represented on the panel are members of the Patient-Centered Primary Care Collaborative (PCPCC). The PCPCC is a coalition of various stakeholders who have joined to develop and advance the patient-centered medical home. The Collaborative believes that if implemented, the PCMH will improve the health of patients and the viability of the health care delivery system. More information about the PCPCC can be found at http://www.pcpcc.net/.

The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 125,000 internal medicine physicians (internists), related subspecialists, and medical students. Internists specialize in the prevention, detection, and treatment of illness in adults. For more information on ACP policies, visit http://www.acponline.org/advocacy.

Source: David Kinsman
American College of Physicians