Editorial: Primary care is at crossroads, so let your voice be heard

Several months ago, we issued a rallying cry for the profession to come together to share innovative ideas and strategies in light of something that is becoming more and more apparent: Primary care is at a crossroads.

The response to that call has been overwhelming. There’s fear and frustration but also hope. Dozens of you have already volunteered to be part of our Primary Care at a Crossroads initiative and to serve as members of our Voices of Primary Care Panel that will be writing, blogging, and video/audio blogging about those issues of greatest concern to the profession. What a diverse, solutions-focused, analytical, and innovative group it is already-and extremely representative of what each of you is going through out in the trenches.

Doctors who are just graduating medical school wrote us saying they wish they knew then what they know now-but they still want to follow their path in primary care. Others who are nearing retirement told us that during no other time in their career have so many factors been converging at once that impact primary care physicians. They have offered to share the context and perspectives that only they bring to see what can be done to forge a new path.

One reader, Edward A. Blumen, MD, MBA, CPC, FAAFP, from Illinois, said that primary care must play a pivotal role in the future of healthcare. “I foresee the direction that we are heading is that the primary care physician will be the manager of modern-day medicine.”

Others aren’t so sure what role the future holds for PCPs, and they fear that factors such as third-party payments, the Medicare reimbursement formula, malpractice concerns, and the role of midlevels could be game-changers.

Some of you take a balanced approach in your view of the issues. “I am thrilled with some aspects of the changing landscape of primary care-emphasis on the importance of primary care for a community (or nation’s) health, focus on the patient-centered medical home, and acknowledgment of the gross imbalances in pay, prestige, and expectations between specialty care and primary care,” Jennifer Frank, MD, FAAFP, told us. “I am less thrilled with other aspects-an overreliance on the EHR as a fix to inherent communication problems in healthcare delivery, a continued emphasis on treatment over prevention, novel approaches to those that are tried-and-true, and a sense that specialists and primary care physicians are now being pitted against each other in competition for the healthcare dollar,” said Frank, who is in private practice in Wisconsin.

If you are interested in participating, please drop me a note at tstultz@advanstar.com and tell me a little bit about yourself and your thoughts on primary care. We know that we can’t find answers to all of your challenges overnight. But our hope is that the collective knowledge and ideas of the profession, brought together in this way, can start rounding some of the sharp edges.