What we value...or don't.

An anecdote from the front lines of primary care...

A woman calls our office asking "do you fill out these sports physical forms?" No established relationship with the practice - just a mom needing her daughter's "forms filled out" for a sport starting the next day at an expensive private school nearby. "We have a pediatrician...but they can't see us today? Can you?" Given my practice structure we're able to offer a sports physical later the same afternoon. "How much will it cost?" Eighty dollars is the answer...much less than we would collect from an insurance company if we billed them for such a visit. "Eighty dollars! Walgreens will do it for $60!"

Do they have doctors at Walgreens? Is there any value at all in having your daughter's heart listened to by someone who went to medical school? Is there any value at all for a practice's ability to see someone on short notice? Does quality primary care still matter...or should we just go the "forms department" at our local convenience store for our care? Over $20k per year being spent for this girl's high school education and I have to justify why the care I provide as an accessible, quality physician is worth $20 more than what is purchasable at Walgreens.

I wish stories like this were rare. The truth is that primary care has been so systematically devalued by the government, third-party payors, medical schools and even many physicians that this attitude is neither unique nor surprising. We need to do a much better job of explaining that health outcomes are significantly improved when primary care physicians are the first point of contact for patients. We need to do a much better job of explaining the various roles of physicians, nurse practitioners and physician assistants and when they are and are not interchangeable. We need to do a much better job of enlisting our specialty colleagues in the fight to save primary care in this country.