Tuesday, November 4, 2008

Dear Doctor, I can help....

The demise of the PCP

Tonight, as I watch the results from the polls come in via internet and TV, I have other things on my mind. Yes, I’m intensely concerned about the outcome of the election. Why else would I have the repeated drivel pouring into my ears and eyes? But one topic really bears weight because it is close to my heart (and pituitary gland, and thyroid and…). Well, you get my drift.

Healthcare has been a topic of much discussion with this election. The medical blogs are full of discussion about it and it seems everyone has an opinion. The PCP shortage is at the root of the problem according to many of the blogs, and poor or inequitable reimbursement is the culprit. The problems are in black and white for all to see.

But who is reading these blogs? Who is listening? Frankly, I’m afraid the very folks who are affected most by this are the last to read and know. Yes, I’m talking about me. And I’m talking about everyone else. I’m talking about “The Patient”.

I suspect the percentage of everyday patients who read medical blogs is very small. The percentage of patient readership of the New York Times health blog might be a bit bigger than the normal, everyday blog. But when there are millions of patients affected, how many actually know the core of the problem?

Sure, ask anyone. They can tell you there is a healthcare crisis. But ask them what caused it. They’ll say “big insurance”. Or perhaps a politician or politicians. Or the influx of immigrants. You name it, they’ll have a reason. Nonetheless, how many do you think will name the PCP shortage and the crisis it will (and has) caused?

I took a poll. I asked 22 people today why there is a problem with healthcare in the U.S. I got umpteen dozen answers, with the most popular being “insurance is too expensive”. Not one person mentioned there was a shortage of PCP’s. Not one person knew that PCP’s were reimbursed at a much lower rate than specialists, and not one person realized PCP’s didn’t make “big money”.

No, I didn’t define big money, and no, the poll wasn’t very scientific. But it does bring home my point. If you want change, you need to tell those who are affected by this crisis what is really wrong! Dear doctors, writing blogs targeted to other health professionals is all well and good. Banding together and working together is a great strategy. But it’s only half the battle. It actually is probably less than that. You need to get us (the patient) involved.

How? Ok, good question. I have a few suggestions:

  1. Target patient groups: The Cushing’s online community/support group is a very large one. Diabetes, MS, and other illnesses have large, vibrant support groups, too.
  2. Draft a letter or some ideas for patients to use when talking to others, including their representatives in D.C. Help the aforementioned target groups tailor them to suit their patrons.
  3. Target your posts to a wider audience. (Dr. Rob at Musings of a Distractible Mind does a great job of that.) Speak in “patient-ese”, not “doctor-ese”. Plain language with a strong message. No whining. Just facts.
  4. For those target groups who have newsletters and/or BlogTalkRadio shows, get on the shows and send in articles for the newsletters.
  5. Band together. Form a group. Wait, insert “organized” into that. Sure, you have all sorts of “organized” groups for blogging. But do you have one for educating the masses?

I’m sure there are other ideas I haven’t thought of, and I’ll probably come up with more myself if I think hard enough. My point, though, is that YOU need to come up with some ideas and act on them. And involve me, the patient. I do care.

Patients, for more information:

From Dr. Rob:

Holes in the bottom of the boat
What is an Ounce of Prevention Worth?
The Good Guys Sometimes Win

From Dr. Theresa Chan:
Why I Left Primary Care, Part 1
Why I Left Primary Care, Part 2
Why I Left Primary Care, Part 3

From PookieMD:
Resuscitating Primary Care, Part I
Resuscitating Primary Care: Part II

How much should I make?
Red Hot Hospitalists And Expanding That Fixed Pot.
Black Tuesday For Primary Care: Why Physicians Would Rather Do Anything Else
Great health care--getting it is getting harder
Why primary care doctors are a dying breed

Various and sundry linked from KevinMD

1 comment:

  1. Well Done! It warms the hearts of PCP's to see people understanding. I still get people thinking it is just whining about money (got a comment on that today, in fact). The bottom line is that the system won't tolerate loss of PCP's. It must be addressed.

    Hats off to you, Robin.



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