How WellcomeMD helps ease the primary care crisis
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An anguished opinion piece by a healthcare policy expert recently appeared in The Washington Post. It was headlined, "The shrinking number of primary-care physicians is reaching a tipping point," and the author told of panicked friends who call her because they cannot find a physician.
It was the latest voice in a rising chorus of commentators that was first heard 20 years ago. Americans have fewer and fewer family medicine or internal medicine doctors to turn to, and the problem is accelerating.
More of us are doing without needed medical attention, or are relying on urgent care clinics, she writes, adding that "Rapid-fire visits with a rotating cast of doctors, nurses or physician assistants might be fine for a sprained ankle or strep throat. But they will not replace a physician who tells you to get preventive tests and keeps tabs on your blood pressure and cholesterol. The doctor who knows your health history — and has the time to figure out whether the pain in your shoulder is from your basketball game, an aneurysm or a clogged artery in your heart."
American physicians, including new medical students, have been turning away from primary care practice in large numbers.
The ones who remain must spend, on average, far less time with each patient in order to keep up, and of course appointments are often far down the calendar, if they're available at all.
A book titled Patients in Peril: The Demise of Primary Care in America notes that "The last 100 years have seen an astonishing drop in the percentage of American physicians who practiced primary care. In the early 1930s, 87% of private practice physicians were in general care; by the early 1960s, this percentage had dropped to 50%.
Starting in 1960, increases in specialists began to outpace increases in primary care." The figure now: only 25 percent of doctors practice primary care.
WellcomeMD, as a membership-based medical practice, has a special contribution to make, by offering those who have a strong interest in their health an alternative: patient-focused rather than production-focused medicine, made possible by a radically smaller group of patients per doctor.
Our physicians and patients have opted for this kind of practice because it offers them, and their doctor, a relationship that leads to better diagnostics, more effective preventive medicine, and prescribed lifestyle adaptations, as well as pharmaceuticals that are tailored to the individual.
A reasonable objection, however, is that this kind of healthcare is costly, and indeed there is an annual fee for WellcomeMD's primary care. But an appropriate question is, "Compared to what?"
At our clinics, the membership fee is not much more than the annual cost of keeping a couple of dogs, and a good bit less than Americans spend on entertainment, on average. We number among our patients truck drivers, schoolteachers, tradespeople and university faculty, as well as more affluent folks.
The larger context, all too familiar, is that the disappearance of primary care doctors is just one of the ills of our current healthcare system. A recent report by the non-profit Commonwealth Fund notes that:
Health care spending is far higher in the United States than in other high-income countries, yet we're the only country that doesn’t have universal health coverage.
Americans see physicians less often than people in most other countries and have among the lowest rate of any kind of practicing physicians, of hospital beds per 1,000 population.
The U.S. has the highest rate of people with multiple chronic conditions and an obesity rate nearly twice the average among the 37 democracies with market-based economies that make up the OECD.
While we wait for those national challenges to be addressed, individuals and families face, day in and day out, narrowing choices about how best to care for ourselves, how much of our personal resources to direct toward maintaining our health, and hiw to achieve even better health.
At WellcomeMD, our mission continues to be: "...to provide comprehensive, preventative, and proactive care for all of our members. Our physicians and their teams are committed to not only improving patients' outcomes, but also improving their quality of life."
