A wave of retirements and not enough doctors taking their places is causing an increasing reliance on a series of other health care providers with less formal training.
Dr. Chris Hakim lives in a version of the not-so-distant past.
But those forces causing changes have been “turbocharged” in recent years, according to Hakim. The rheumatologist saw firsthand how some patients, particularly older ones, struggled to deal with the shifting landscape of obtaining care from people facing their own pressures in providing it. They all share the drive to make people feel better, whether they are nurse practitioners or physician assistants, and they are referred to differently depending on whom you ask — physician extenders to some, advanced practice providers to others. Regardless, they are stepping up to fill the breach as a shortage of primary care physicians crests as the average age of Americans continues to grow older.
The transactional interaction means depending on service units times the number equals the reimbursement and primary care loses money in many ways, Pearman said. “The trick is to be efficient enough to hone in on the most important things during that encounter and maybe address things outside the encounter if they pop up,” Pearman said.
Coordination of services provide different types of access meant to address people’s needs, Pearman said. For example, in chronic care management, there are likely those who’d rather receive an in-depth call each month than wait six months to see a doctor face-to-face with a list of issues that have worsened in that time, according to Pearman.
“If there’s a limit of access to care because there’s not enough providers, then certainly preventative care measures are going to be sacrificed and we’re going to have more chronic conditions,” Schmude said. “So there’s a domino effect.”Very low out of-pocket/no out-of-pocket costs is a major incentive that drives patients to physicians for preventative care and in commercial groups, build incentives as well for preventative care, according to Schmude.
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