Primary care physicians are indispensable for an efficient and operative health care system. Despite their major responsibilities, the structure of the US health system undervalues the level of primary care. In addition, the medical model of our health system currently discourages medical students from entering the field of primary care. This is in part a result of financial disparities between primary care physicians and specialists; debt incurred from medical school is becoming a growing factor in students’ choices to specialize. However, the economic shortfalls of primary care are not the main explanation for the primary care shortage that the US is facing. The current structure of primary care hinders primary care physicians’ abilities to provide quality care to their patients; their workload is unmanageable and they cannot possibly provide personalized care for each of their patients, especially in a system that values the quantity of procedures performed (the role of specialists) rather than the quality of care provided through doctor-patient interactions. The level of primary care requires reform; patient care teams should be created instead of relying on loan reimbursements to incentivize prospective physicians to enter the field. Patient care teams have been proposed as a potential option and would improve patients’ quality of care while making the workload of primary care physicians more manageable, overall having a positive effect on primary care as a whole. Patient care teams would restructure the primary care environment by expanding the role of other clinical workers, specifically nurse practitioners, who would take on some of the responsibilities currently performed solely by primary care physicians. The common assumption is that the physician is the sole authority who makes decisions, but this needs to be reassessed. Within patient care teams, physicians would have a similar role with the other team members, and everyone has a say in the team’s actions. Nurses and other clinicians would see patients who need routine checkups or tests done that do not require the physician. Splitting up the responsibilities in this way allows the physician to spend more time with a few patients who do require consultation with them. There are potential drawbacks to a team of practitioners working in a primary care setting, and communication between each professional would be key. Do you think patient care teams are a feasible and potentially effective solution to alleviating the stress primary care physicians currently have, and in preventing the shortage of primary care physicians from progressing?
For reference, the links below provide more information on the logistics of patient care teams: http://jama.jamanetwork.com/article.aspx?articleid=198334#TheProblemsWithTeams