HomeWhat's NewPerspectivesHope for Primary CareLetter from Louis A. Kazal, Jr., MD

Hope for Primary Care

A letter from Louis A. Kazal, Jr., MD
Dartmouth-Hitchcock Community Health Center - Lebanon, NH

It often takes a crisis to wake up Americans.  Churchill said "you can always count on Americans to do the right thing— after they've tried everything else."  So here we are with a looming primary care crisis in America and heavily monied interests in the way of doing the "right thing".  The primary care community has been sounding the alarm for many years now.  The recent report of the Physicians' Foundation shows just how acute things are.

Yet there is reason to be optimistic about the future of primary care.  At the macro level, the Obama administration recognizes the critical need to reform health care.  We also see a growing mountain of evidence that a strong primary care foundation is a pre-requisite for a highly functioning health care system.  Finally, we see family physicians on the ground, transforming their practices one by one, some faster than others, but none the less, marching forward.

In our academic practice at a large academic medical center, despite many challenges, there is great hope for the future and a growing sense of appreciation for primary care.  Our practice helped lead a tremendously successful CMS demonstration project highlighting for the institution how valuable primary care way can be (beyond RVU generation).  We anticipate a new EHR in a couple of years that will improve on our current attempts using disease registries; private insurers are being pushed to pay for comprehensive care for patients as opposed to episodic care; and stronger and more complete teams are forming to make sure patients get what they need when they need it. 

All these things convince us that primary care will flourish when given the right support.  TransforMED has been an important effort by the American Academy of Family Physicians to make the Future of Family Medicine a reality in everyday practice. 

The report of the Physicians' Foundation is not a surprise to our leaders; it is telling us what we already knew, which is why TransforMED came about in the first place.

Louis A. Kazal, Jr., MD
Dartmouth-Hitchcock Community Health Center
Lebanon, NH

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