There’s a good reason for the intensifying desire to shift more responsibility to primary care physicians. Studies conclusively show that when primary care handles the bulk of patient care, good things happen.
But as we march toward patient-centered medical homes and increased physician responsibility, the unrelenting challenges of physician shortages and shrinking reimbursements have taken a toll on the patient-physician relationship in the U.S.
According to a Consumer Reports study, more than 75 percent of doctors think forming a long-term relationship with a primary-care physician is the most important thing a patient can do to obtain better medical care. But in today’s environment, this relationship is growing all too rare. Some patients can’t find a doctor. Some don’t want one. And some don’t value the one they have.
In a recent survey, nearly a third of Americans who don’t have a primary care physician said they didn’t think they needed one. Another survey showed that about half of men ages 18 to 50 don’t have a PCP, and a third haven’t had a checkup in more than a year.
In the Consumer Reports research, patients reported mixed levels of satisfaction with their doctor. Those with more complicated health statuses reported being less satisfied with their primary care. Patients managing chronic conditions were significantly more likely to complain about ineffective treatments, and only 31% were highly satisfied with their doctor overall.
Meanwhile, 70% of doctors say they are getting less respect and appreciation from patients than when they started practicing. About 1/3 of the physicians surveyed said patient non-compliance significantly impacted their ability to deliver effective care.
It’s not terribly surprising that relationships between patients and physicians are strained. Doctors have been trapped in assembly line medicine, impeding their ability to effectively work with patients during visits, much less provide guidance and support once the patient leaves the office. Meanwhile, patients are being trained by other consumer experiences to expect more convenience, personalization and technological advancement from their encounters. Something medicine just hasn’t been able to keep pace with, until recently.
The growing hope that primary care can be the hero of healthcare is spot on. But to see that hope realized, we must appropriately equip and support physicians to deliver proactive, personalized care during and between visits. We have to educate patients on the value of primary care and how to effectively engage. And most importantly, we have to repair the strained relationships that have occurred because of a broken, inefficient system and usher in a renewed pact between patients and their physicians.