Congress should pass legislation that promotes convenient and time efficient outpatient care. This would be achieved by putting in place more general practitioner clinics with specialists also on hand. The U.S. would follow a system more like the one in place in Europe. A patient goes in to be seen by a general practitioner for whatever ailment, the general practitioner is able to identify what type of problem the patient is experiencing and then refer them to a specialist in the building. The patient is then able to be seen by that specialist, most likely, that same day. This would be much more cost and time efficient than the urgent care clinics that we currently have in place in the U.S.
According to Shi and Singh, evidence suggests that a high proportion of primary care professionals/general practitioners in a population results in lower health care expenditures. There are two key factors that determine the proportion of general practitioners to specialists that are needed to ensure the sufficient use of primary care. One is how firmly the health care system utilizes the concept of gatekeeping. If the general practitioner clinics demonstrate some slight leniency of how quickly and easily they refer a patient to see a specialist, the issues may be resolved quicker. This, in turn, will cost less for the patient and health care system. The second factor is influencing the primary care providers/general practitioners to urge their populations to make use of the primary care services. If the use of primary care is increased, it will reduce the need for more expensive secondary and tertiary care methods, therefore reducing costs for the patients, and most importantly increasing early detection and the overall health status of the population.
Congress should regulate the concept of gatekeeping. As it is right now, patients are making appointments to see specialists that they might not even need to see. Specialists are booked for weeks and sometimes it’s really difficult to make an appointment with one. If more general practitioner clinics were put in place, specialists would be more accessible and patient outcomes could be improved. Patient satisfaction would be improved as well as patient retention.
References:
Shi, L., & Singh, D. A. (2008). Delivering health care in America: A systems approach (4th ed., pp. 252-253). Sudbury, MA: Jones and Bartlett Publishers.
Brunner, S. (2009, October 1). Analysis of national general practitioner patient survey data in England. Retrieved from http://www.medicalnewstoday.com/articles/165807.php
Centre for Reviews and, D. (2002). Does primary medical practitioner involvement with a specialist team improve patient outcomes: a systematic review (Structured abstract). British Journal of General Practice, 52934-939. Retrieved from Database of Abstracts of Reviews of Effects database.
Mas, C., Albaret, M., Sorum, P., & Mullet, E. (2010). French general practitioners vary in their attitudes toward treating terminally ill patients. Palliative Medicine, 24(1), 60-67. doi:10.1177/0269216309107012.
Piterman, L., & Koritsas, S. (2005). Part II. General practitioner-specialist referral process. Internal Medicine Journal, 35(8), 491-496. Retrieved from MEDLINE with Full Text database.
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I agree that gatekeepers are necessary to control a high population of patients at specialists. Implementing gatekeepers would be a great way to cut down on high health care costs. My only apprehension would be that if I wanted to see a specialist and couldn't find a doctor to recommend me to them I would be very frustrated.
ReplyDeleteGood idea! I think it's pretty obvious that there are too many specialists and not enough primary care doctors in the US. But what incentive could the government offer to doctors to practice primary medicine instead going into a specialization? A gatekeeper system would help to slow down the overutilization of specialty care.
ReplyDeleteSpecific departments within a multi-speciality clinic will require a referral from the patient's primary care physician or they may possibly get that referral as a result from care in an emergent or urgent situation. Example - a patient cannot make appointment for a surgeon visit or physical therapy.
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