Tag Archives: primary care

Future of primary care: Who will take care of you?

The list of problems with primary care today is long and long-standing. Patients are frustrated and confused. Providers feel pressure to see more patients even as their reimbursements go down. Medical schools push students toward hospital-based sub-specialties. And for those who choose primary care, the training neglects important new skills, such as working in a team and engaging patients in their own care.


A new tip sheet from Felice J. Freyer, a medical writer at The Providence (R.I.) Journal and a member of AHCJ’s board of directors, addresses the changes in primary care and offers a number of story ideas and resources for reporters to cover primary care in their communities.

All this as the nation prepares for a spike in demand for primary care providers – fueled by millions of patients newly-insured through the Affordable Care Act – and a drop in supply due to retirements in the aging physician workforce and the unpopularity of the specialty, according to four panelists at Health Journalism 2013.

“I hate to be a downer,” said Andrew Morris-Singer, M.D., president and principal founder of Primary Care Progress. “We do have profound problems in the primary care pipeline.”

Solving the problem boils down to making essential changes to the way primary care providers do business, the panelists agreed.

These practices of the future – some of which already are operating – emphasize engaging patients, using technology, and distributing patient care across a primary care team. Continue reading

Panel of primary-care providers at Health Journalism 2013 #ahcj13

A look at some of the issues, sessions and ideas to keep in mind for those planning to attend Health Journalism 2013, the annual conference of the Association of Health Care Journalists.

If you’re looking for a thrilling health care story, the local primary care practice is probably not the first place you turn. Primary care is tough to write about, tough to illustrate: the day-to-day interactions in the exam room pale before the cool stuff like robot-assisted surgery or brain-mapping.

Yet there are few more vital – or rapidly changing – sectors in health care. Want to better manage chronic illness? Prevent hospital re-admissions? Promote electronic health records? The primary care provider has got to be at the center of any such efforts.

And what will happen when millions of people who obtain insurance under Obamacare start to look for primary-care doctors, already in short supply?

For a better grasp of these issues – and an infusion of enthusiasm – come to “The Future of Primary Care: Who Will Take Care of You?” at Health Journalism 2013. The panel, at 4:40 p.m. on Saturday, March 17, will feature four primary-care providers working on innovations that may surprise you.

Learn how one practice became a 365-day-a-year operation, based on teamwork, driven by data. Hear about a practice where providers don’t try to cram in 30 patients a day, but take as much time as they need with each. Find out about a trainee-led movement in medical schools around the country to promote primary care, change the way it’s taught, and encourage more doctors into the primary care workforce. Hear about what new skills primary care providers are learning to function in a changing environment.

You can expect to walk away with an armload of story ideas, and a new appreciation of the potential role for primary care in redesigning the health care system as a whole.

Rural health care in Calif. nearing ‘crisis’

In a collaboration between the California HealthCare Foundation Center for Health Reporting and the San Francisco Chronicle, the center’s David Freed ventures into rural Mendocino County in northern California to explain and examine the ongoing (and worsening) shortage of physicians in American rural areas.mendocino-ca

Ukiah emergency room physician Marvin Trotter says that within the next five to seven years, the shortages will grow into a “full-blown health care crisis.” It’s a crisis about which the 58-year-old doctor speaks with eloquence and force.

“You’re going to see more complications and a lesser quality of life,” said Trotter, who puts in 12-hour days three days a week in the emergency room at Ukiah Valley Medical Center, the town’s only hospital. “You’re going to have your foot cut off more as a diabetic. You’re going to have more heart attacks because nobody’s taking care of your cholesterol. You’re going to have more people lose their vision because they can’t get in to see an ophthalmologist. That’s all a function of physician accessibility, and accessibility’s going away.”

Trotter’s quote is a reminder that, for rural America, “doctor shortage” means far more than just primary care. For a broad overview of the growing rural physician shortage, I recommend the “Older doctors, fewer hours” subheading on the story’s first page. The following subhead, “Scarcity at critical levels,” offers a deeper look.

In the second story in the package, Freed looks at how rural communities are working to solve the shortage, and why their efforts keep falling flat.


Program Draws Medical Students to Fresno: A program for third-year medical students is hoping to fight something long intractable: a shortage of doctors in rural and impoverished areas.

New website features center’s health reporting
Calif. organization names AHCJ members to staff
Calif. foundation backs new model; will be hiring
Nonprofit, paper team up for project on med school
Project launches test of a new model for health journalism

How will aging doctors affect your community?

AHCJ member Ryan Sabalow, a reporter at the Redding (Calif.) Record Searchlight, recently looked at the age of doctors in his county, finding that “nearly two thirds of Shasta County’s doctors are older than 50, and there aren’t nearly enough young doctors lining up to replace their retiring peers.”

Sabalow freely admits he’s not the first to cover the topic and acknowledges the work of Ventura County Star reporters over the summer. In a Reporting on Health blog post, Sabalow suggests that reporters contact the state medical board and request the an age range of physicians in their county.

The Association of American Medical Colleges forecast that the “passage of health care reform will increase the need for doctors and exacerbate a physician shortage driven by the rapid expansion of the number of Americans over age 65.” For a look at how many physicians are practicing in each state, as well as how many are in school, see the organization’s state-by-state statistics.

Some resources on workforce issues for AHCJ members:

Assessing acute care in America

The New York Times‘ Kevin Sack reports on a Health Affairs study that explores “acute medical care,” particularly initial visits for the fever and cough type of stuff that would traditionally go to a primary care physician. While 42 percent of such visits were still handled by a patient’s personal physician, a full 28 percent took place in emergency rooms. According to Sack, that number includes almost all visits made outside of typical office hours, as well as most visits made by patients without insurance.acute1

More than half of acute care visits made by patients without health insurance were to emergency rooms, which are required by federal law to screen any patient who arrives there and treat those deemed in serious jeopardy. Not only does that pose a heavy workload and financial burden on hospitals, but it means that basic care is being provided in a needlessly expensive setting, often after long waits and with little access to follow-up treatment.

Reform provisions such as medical homes, accountable care organizations and more money for primary care seek to rebalance acute care delivery in the United States, but Sack reports that the study’s authors fear it won’t be enough.

The authors warn that it might not be enough. “If history is any guide, things might not go as planned,” they wrote. “If primary care lags behind rising demand, patients will seek care elsewhere.”

Remember, free access to Health Affairs is one of many perks enjoyed by AHCJ members.