Primary care and the keys to its success

Key Points

Primary care physicians (PCPs) are frustrated. They wrestle with rising costs, yet revenue for their services inched up just 1.8% in 2010. And that represents less than 40% of hospital spending growth.

A recent report by Physicians Foundation concludes: "Physician morale has fallen both because of these economic pressures and because of the failure of health system reform to address how to improve professional practice."

To add even more pressure on the primary care sector, younger doctors are reportedly favoring salaried positions instead of assuming the risks of owning practices simply because of uncertainty, says Lou Goodman, PhD, president of the Physicians Foundation and chief executive officer (CEO) of the Texas Medical Society.

According to the report, the number of doctors entering salaried positions within hospitals has been exaggerated. In 2010, physicians employed within hospital systems only represented 15% of the physician population. "In addition, hospitals have neither the economic resources, nor management capacity, to absorb a much larger portion of the practicing physician community."

"There is a real opportunity for PCPs," he says. "Populations are aging, and demand for care is going up. Primary care is at the center of that, and the rewards for primary care will increase linearly in coming years."

Goodman believes that although the future will see midlevel providers playing a greater role in primary care, they will never replace doctors.

"The idea that nurse practitioners or physician assistants can fill the vacuum is not accurate," he says. "They can do some things, but someone needs to make the unequivocal diagnosis, and the person who is best qualified to do that is a physician."