A Martian's Prescription For Primary Care: Overhaul The Physician's Workday

Weill Cornell Medical College, New York City, NY, USA.
Health Affairs (Impact Factor: 4.64). 05/2010; 29(5):785-90. DOI: 10.1377/hlthaff.2010.0133
Source: PubMed

ABSTRACT What would a Martian arriving on earth think about how U.S. primary care physicians spend their time? She or he would probably reach the same conclusions as this essay: that a new model for primary care should not be based on physicians' seeing a high volume of patients. On the contrary, physicians should see a relatively small number of patients, perhaps eight to ten daily. Thus liberated, they could spend more time with patients who need it; could have adequate time to communicate via phone and e-mail with patients, physicians, home health nurses, and other providers; and could actively coordinate the care of the practice's population of patients. Although articles about new care models such as the patient-centered medical home imply that physicians should work differently, they rarely mention this fundamental transformation of the workday. I suggest reasons for this omission and ways to overcome barriers to redesigning physicians' workday.

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