The Family Doctor: A Remedy for Health-Care Costs? – of course I object to the title. This article champions the patient centered medical home, which the ACP and internists embrace. Internists or family physicians can lead adult medical homes. But then, I understand the most pundits and politicians do not understand what an internist is.
The article is good and includes this priceless paragraph:
As sensible as this routine may sound, it goes against the grain of most primary-care practices. Medicare and other insurers pay doctors on a fee-for-service basis that rewards quantity of care over quality. There are no reimbursements for discussing diabetes management with a patient, say, or talking over a case with a specialist. “The main hurdle to getting the medical home accepted more widely is the lack of compensation for cognitive work,” says Harvard Business professor Clayton M. Christensen, co-author of The Innovator’s Prescription: A Disruptive Solution for Health Care.
How many times have I written about this concept? We will have inadequate health care reform if we do not fix the payment system to encourage primary care physicians to spend extra time with patients. We will have inadequate health care reform if we do not fix the payment system to encourage physicians to become primary care physicians.
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