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Doesn’t anyone have a family doctor anymore? Apparently not.

In this month’s Health Affairs journal, a startling new finding – 42% of the annual visits for acute care happen somewhere else other than a primary care doctor’s office. These are visits for new problems and are usually exactly the kind of thing a family physician, pediatrician, or internist should be first to speak with a patient about. Instead, patients are being seen in emergency rooms, specialists’ offices, and outpatient clinics, three of the most expensive places to get care in our system and three of the places least equipped to deliver high-quality primary health care.

On the one hand this shouldn’t be that surprising. After all, we pay twice as much for our health system as any other wealthy country and, as anyone with extensive experience with the system knows, often get disorganized and maddening service despite this enormous expense. A refocus on primary care is part of the new health care law. Primary care doctors will be paid more, preventive services will be exempt from all copays, deductibles and other charges for almost everyone next year, and new ways of paying for care that stress the importance of the family doctor are already being studied.

However, as this research shows, the system will need pretty substantial change to shift the focus away from the lower-quality and more expensive ways of delivering care.

4 Comments


  1. Alex

    September 7, 2010 at 9:11 pm

    What about when you call your family Doctor and they pass you off to a Specialist or ER before seeing you and then those folks pass you back to the family Doctor?

    The problem I see is the insurance will not pay the family docs enough so they only want the simplest stuff and I do not blame them.

  2. Adam Searing

    September 8, 2010 at 10:38 am

    I agree – primary docs should be paid more and they will be under the new health care law.

  3. Cathy

    September 8, 2010 at 6:04 pm

    United HealthCare, Blue Cross, Aetna and Cigna pay primary care physicians less for a “Preventive Care Exam” for a 40-64 year old, than I pay my dental hygenist to clean my teeth.

    Unless you are a medical claims coder, you would not know that the promise of “free physicals with no cost sharing, copays or deductibles” reeks of fraud and does not follow current CPT procedure coding guidelines.

    If a patient schedules a preventive care exam and they have pre-existing conditions and/or new complaints that are addressed during the preventive care exam, coders are instructed to use an “Evaluation and Management” code with modifier#25 indicating a separately identifiable service was provided by the same doctor on the same day as the preventive care exam. The majority of 40-64 year olds have numerous problems…hypertension, diabetes, high cholesterol, arthritis with joint pain and women have menopausal issues… Patients feel deceived when they are responsible for a deductible or co-pay and it’s simply because they are NOT being told the truth when their policy is sold. It’s a nightmare for healthcare staff and it discriminates against most patients. Yes, I have written to the federal “Preventive Care Task Force”. Let’s hope they listen and communicate the truth to the public.
    I am a medical practice administrator.

  4. Family Doctor

    September 28, 2010 at 6:25 am

    […] The Progressive Pulse – Doesn't Anyone Have A Family Doctor … […]

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