Primary Care Done Right – The Five Key Elements to Improving Primary Care

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A growing shortage of physicians coupled with rising costs and stronger patient demand are pressuring the U.S. healthcare industry in ways we’ve never seen before. Transforming care delivery starts with specialists, hospitals and emergency rooms being reserved for those patients that need it the most while moving more services to primary physicians.

Yet for primary care to be effective, it must be convenient, accessible, comprehensive and delivered in the most efficient manner possible. Through strategies like virtual capabilities, extended hours and a team-based approach that makes the best use of their time and resources, primary care physicians can play a strong role in reducing costs and improving patient outcomes.

Below are five key elements to improving primary care:

Faster Appointment Bookings and Same Day Access

Primary care done right requires that it be accessible when patients need it. Nowadays, it is all too common for patients to wait weeks to see a physician for common conditions. Research by Merritt Hawkins found the average patient wait time to see a practitioner in 2016 was 29.3 days, an increase of 50 percent since 2014.

Delays impact not just patients but providers as well. Waiting to see a physician adds to the complications and cost when the patient ends up with fragmented, unfamiliar care in a random urgent care center or a hospital emergency room.

A study published in the U.S. National Library of Medicine at the National Institutes of Health found 75 percent of patients want or need a same-day appointment. One of the most efficient ways to ensure advanced access is a shared or pooled practice among at least 2-3 primary care physicians. This offers greater efficiencies and better access for the patient while also addressing continuity concerns with a real-time electronic medical record.

Extended Morning, Evening and Weekend Hours

Another element of primary care done right is expanded hours to increase convenience and better meet the needs of patients. At a time when many patients are financially overwhelmed, many are hesitant to miss work for non-emergency appointments. And when coupled with the long wait times, it further contributes to them delaying the care they may need.

Hospitals and Health Networks reported in April 2015 that the most desirable appointment times were between the hours of 7 and 9 a.m. A recent study by PLOS Medicine in the UK also found that practices that extended their hours beyond 8:30 a.m. to 6:30 p.m. experienced a 26 percent reduction in patients seeking emergency departments visitors for minor problems.

Advisory and accounting firm EisnerAmper says staying open longer enables physicians to better compete for patients and drive revenue. It can also reduce ER visits and hospitalizations, improve health and create customer satisfaction.

Virtual Care

From prescription refills to minor complaints, many of today’s primary care issues can be resolved by phone or by virtual interaction then referred to an office visit for further examination when needed. Based on data from the National Ambulatory Medical Care Survey, we believe nearly half of all traditional primary care visits could be accommodated through such non-traditional models.

Virtual care is an effective means of improving primary care, increasing access and convenience for patients and saving costs for both patients and providers. The ever-expanding array of applications and devices, ranging from mobile phones and heart rate monitoring smartwatches to blood pressure cuffs, physicians can now obtain data and assess many common situations without an office visit.

Virtual care is now being use in both primary and hospital settings. Healthcare IT News reported that Tallahassee Memorial Hospital in Tallahassee, Fla., regularly saves up to $1 million per year in cost avoidance through its telehealth platform.

Team-Based Care

Nonphysician providers are a key component of delivering care in many rural communities across the United States. A study in Health Affairs indicates that as much as 70 percent of office-based primary care could be delivered by advanced practitioners.

Geisinger Health System in Pennsylvania uses a “shared practice approach” as part of its medical home model with groups of two to four primary care physicians supported by nonphysician professionals. Nurses and advanced care practitioners, which compose over 40 percent of their workforce, practice at the top of their license to provide all care that doesn’t explicitly require a licensed physician. Office staff are also authorized to prompt patients to schedule screening exams and procedures as noted in their medical record.

Such a team-driven model enables physicians to reduce time spent on lower level tasks to focus more on issues that require their expertise and recommendations.

Comprehensive Care

There’s evidence that more comprehensive care through a primary care physician’s practice can result in lower costs and fewer patient admissions. A study by the University of Chicago Medicine examined 2,000 patients and found that those who had access to a comprehensive care physician (CCP) were 15 to 22 percent less likely to be hospitalized during that time. They also gave their physicians higher rates, expressed greater satisfaction and had better health outcomes.

With payment reform driving care to the least expensive and most effective setting, research suggests that visits to specialists will decline and more pressure will be put on comprehensive primary care.

Now is the time for primary care physicians to make a tremendous positive impact on the U.S. healthcare system. Through things like virtual capabilities, comprehensive team-based care and longer hours, we can make healthcare more accessible, convenient and effective.


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