![]() No segregation of patients within the same clinic, because all patients would be "concierge class" in this model. ![]() No unfamiliar places and provider off hours. No more having to miss school or work for doctor visits. Care would be affordable even for uninsured, cash-paying patients - and would fit several primary care payment models - insurance, direct primary care and concierge - simultaneously, under one roof. This model normalizes the personal doctor-patient commitment, which is the only way patients maintain access to the practice and its services. and include routine, preventive, chronic or urgent visits. Care would be available anytime - even at, say, 3 a.m. This clinic would always be open, always staffed and always ready to see established patients. To achieve this, we will need to fundamentally change our practice logistics to embrace patient care around the clock, as doctors have done for millennia - but now in the context of a 24-hour clinic.Įnter a practice arrangement in which seven to 15 doctors work on rotating shifts in a physical clinic they themselves own and operate 24/7, 365 days a year. ![]() Here, then, might be a golden opportunity for family physicians to address this elusive Triple Aim by embracing two key elements largely missing in today's health care system: personal continuity of care and authentic commitment between the physician and patient. health care remains mostly unrealized, and care has never been more fragmented, patients more dissatisfied or physicians more demoralized than right now. Despite a decade of efforts, this common goal of U.S. They call it the Triple Aim: three core tenets of higher quality of care, reduced cost of care and expanded access to care. As it turns out, doctors, patients and payers alike agree on their most critical need. To avoid impending demise, independent primary care must evolve to fill a market niche. Now a rarity, small primary care practices - even those still thriving today - risk succumbing to this tide of obsolescence, not unlike local department stores and indoor shopping malls.īut the most powerful innovations are borne of necessity. Unlike many other specialists who still see patients during nights and weekends, primary care is now conspicuously absent in that important space, putting more pressure on family physicians to justify the level of reimbursement that can support independent practices. doctors who partly or fully owned their practices dipped below one-half.Īs inpatient care became a separate field, primary care was mostly sidelined into a 9 to 5 office job in a role now shared with midlevel practitioners, retail clinics and telemedicine services. ![]() No wonder that in 2016, for the first time, the proportion of U.S. Family medicine has been the most highly recruited specialty for more than a decade. With demand and salaries for employed FPs continuing to increase, the prospect of starting or joining a private practice and treading water in a sea of acronyms (MACRA, HIPAA, HMO, ACO, etc.) for margins that barely cover overhead no longer makes sense to most family physicians.
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