The Healthcare Gap: Returning to Full Service Primary Care

In the third blog in our series on The Healthcare Gap, the business takeover of medicine was highlighted. This business takeover has led to:

  • Patients receiving less care at the primary care provider (PCP) office

  • Patients seeing someone other than the PCP they know and trust

  • Increased referrals for the healthcare issues that “take too long” and decrease profit

  • Intentional overbooking of patients to maintain the desired quota that makes the most money

These harmful results helped create the gap that the CEO of the urgent care recognized, which I discussed at the outset of this blog series. These issues and the gap created pose an important question for the future of medicine. Namely, if patients cannot be seen by their PCP on short notice, where do they go?

Urgent Care Seems to Fill the Gap Between the PCP and the ER

When a patient cannot see their PCP on short notice, the emergency room (ER) is, almost by definition, a poor option. As the name suggests, the ER’s priority is emergency medicine. Medical issues that fall short of an emergency, including those that require attention on short notice, do not receive adequate care at an ER.

That is why visiting an ER with a non-emergent issue often leads to:

  • Wait times of several hours

  • Patients being charged a large fee

  • Patients who leave unhappy since the ER did not provide the care that was needed

Patients should not be surprised that the ER is an inadequate way to address non-emergent medical needs. Examples of important, but non-emergent medical issues that the ER is not ideally suited to handle include:

  • A cold

  • Medication refills

  • Minor lacerations or fractures

These types of issues were meant to be looked after by a patient’s PCP, but the business takeover of medicine has eroded this essential service. Corporate healthcare removed these services from PCP offices, creating a vacuum where these needs were not being addressed.

This is the vacuum urgent cares have been filling for patients, which ought to be commended. However, it is my view that PCPs must return to providing this important service for our communities and patients.

Returning to Full Service Primary Care by Way of Direct Primary Care

In my first blog post on The Healthcare Gap, I mentioned driving home after a 12-hour shift at a local urgent care. On my drive home, I thought about the shift in medicine that created healthcare’s unacceptable gap in care.

My final thought on that drive home was this: Shame on us (primary care physicians) for letting this gap separate us from the communities we serve. We can and must do better.

We must restore the full service primary doctor without the restrictions put in place by putting money and broken business models before patients. This is my primary passion, and that is why I am so excited about what Direct Primary Care (DPC) provides for physicians, patients and the communities we share.

DPC returns medicine to the model of a full service primary doctor, which is why I look forward to providing this service for my patients and the Fryeburg community.

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COVID-19 and the Ongoing Public Health Crisis

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The Healthcare Gap: Harms of Profit-Driven “Productivity”