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Some things are going to change for primary care physicians (PCPs),regardless of how the Supreme Court rules, how Congress responds,or who is in the White House, says at least one observer. "We can't afford our current system," says Paul Keckley, executivedirector of the Deloitte Center for Health Solutions. "It is justnot sustainable." [RELATED: Supreme decision: Healthcare reform hangs in the balance ] With the system continually growing disproportionately to otherindustries or household incomes (about 6% a year), doctors aregoing to have to demonstrate their value or face renewed calls forcuts, he says. "The demilitarized zone between primary and specialty care is goingto be intensified over the next year and a half, regardless of whathappens with the Supreme Court," he says, because the demand forspecialty healthcare is too supply-driven. "The more specialists you have in an area, the more specialty careis performed, and not all of it is necessary," he says."Specialists will fight this notion with every argument they have,but the data show that not everything they do is justified." Altering this dynamic will put PCPs back into the forefront ofmedical decision-making, he says. Primary care can position itself to maximize this situation bytransitioning away from the "see 35 patients a day" model andinstead starting to view physicians as captains of "medical home"teams, determining appropriate standards of care for their patientpopulations. Each team would consist of nurses, nutritionists, home-basedcaregivers, technicians, therapists, and others. The doctors wouldfocus on performing complicated diagnostic workups, reviewingcharts, developing care algorithms, and determining when referralsto specialists are warranted. "They will need to become more of an architect of a set of primarycare interventions rather than the engineers," Keckley says. "Theywill be the coach who channels patients to the right gates ofcare." He believes PCPs should see this development as a positive changebut says many may feel threatened by the fact that they will not bethe one seeing all of their patients. He offered a few tips on howto prepare for this emerging dynamic: If you are not on already on your way to stage 2 of meaningful use,get busy. Having an electronic health record system with clinicaldecision-making support is essential. Start (or continue) to collect data the demonstrate that yourstandard of care works and how much it costs patients. Many physicians say they are too busy to gather and analyze theirpractice data, but they need to change that way of thinking, hesays. "We need to get past the notion that what we say is good careis, in fact, good care. We need data." Start having discussions with local hospitals, which will need moreprimary care participation as healthcare evolves. "Talk to them about how you are going to do this together and askwhat's in it for you," Keckley says. Primary care can "have the wind at its back" in the future, hesays, but the doctors need to be willing to adapt to get there. "The keys to the healthcare kingdom are theirs if they tackle thiswell," Keckley says. "But there is no going back to the days ofMarcus Welby.". The e-commerce company in China offers quality products such as Inflatable Saturn , Inflatable Water Walking Ball, and more. For more , please visit Inflatables Water Sports today!
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