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  • Writer's pictureDr Desai

Primary Care from a Doctor's Perspective

Updated: 1 day ago

When I was a kid people went to the doctor because they didn't feel well. This function has essentially been taken over by urgent care, which seem to have developed into their own sub-specialty.

So currently primary care is an alliance with the patient to enable them to access medical services. Huh?

Primary care is the only field in medicine where we specialize in our patients, not in a disease or body part. We see things from the patient's point of view. I see tech trying to get into primary care - they must see a lot of money to be made. The problem is that only a human can understand another human, so tech has limited utility. Not every option is the correct option for any particular patient. Many people feel the job could easily be done by ancillary staff or NP's but without the medical background you're not really helping.

Enabling access is more difficult to explain. It involves navigating the byzantine medical system, understanding which symptoms are important and which can be monitored, which medications are necessary and at what cost, which specialists are necessary, whether specialists are necessary, whether tests are necessary, what deserves to be managed at home, HHA's, nursing homes, oncology, palliative care, allied health, wellness services, pharmacies and the list goes on. Patients without PCP's have a bad time of it and tech has no place (other than reminding you to give a flu shot when the patient is there after a bereavement). Non-doctors do not have the medical training to juggle all the above and come up with a plan suitable and agreeable to the patient. Insurance companies have failed to code the above activities and don't understand them anyway. 

I believe everyone deserves to have a PCP who is allied with them. With our current levels of spending we can certainly afford it. Most people don't seem to be aware of the importance of primary care. Maybe we should campaign like the dentists - "see your dentist for a cleaning every 6 months".

For primary care to succeed insurance has got to be removed from the equation. We threaten their profitability, as you can tell by their collective aggravated and prolonged onslaught on primary care. Why do people write articles on burnout and doctors leaving the profession when the cause is so readily apparent?


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