Global Conference on Primary Healthcare..... Where does America need to improve?



  • Did you know there is a global movement put forth by the WHO, as part of the 2030 Agenda for Sustainable Development to provide Healthcare for All? It's a very ambitious goal, centering on the year 2030. Many countries have whole governmental initiatives just centered on the year 2030 to immensely transform their societies in tech, green energy, healthcare, and social causes. Saudi Arabia is one such country, prioritizing these changes and looking to sustainability.

    Globally, countries are reaffirming their commitment to their citizens in healthcare. This is fantastic for countries that are looking to care for their citizens, lift people from sickness and poverty and help them with their health. What about here in America? Where are we in the midst of these initiatives? Arguably, we have one of the best medical systems in the world. However, we seem to be lacking in all things; primary care. The frontlines of health, the foundation of sickness or wellness- is rooted in primary care. We need to change this for all Americans. Having a trusted doctor that knows you, your health history and can prevent or catch early onset of chronic disease- is pretty crucial. It also can help people in times of illness where their doctor could easily help them over an urgent care or ER setting; thus reducing costs to our medical systems.

    The benefits of primary care are numerous. What are your reasons for making sure all Americans have a trusted PCP? How do we push the global Primary Care Initiative, here? What can we do and why is this important?



  • Well, a major issue is going to be the Primary Care Physician shortage, estimated to be between 14,88 and 49,300 by 2030.
    The Association of American Medical Colleges has a great recent paper discussing this: https://news.aamc.org/press-releases/article/workforce_report_shortage_04112018/ .



  • @mattrmd That is a very important point. The shortage of Primary Care workers needs to be addressed. It's only made worse by the technology we are currently using. Taking doctors and placing them onto the systems, is not a viable solution. Getting more doctors in front of patients- is the solution. We need to be the organization that not only fixes this but transforms it. https://www.newyorker.com/magazine/2018/11/12/why-doctors-hate-their-computers

    Look for this article to be a Forum discussion!



  • @mattrmd I would argue that we're not having a shortage of primary care physicians. With 2 hours of computer time required for 1 hour of patient face time, we're just being inefficient with time.

    100,000 physicians * 5 hours/day computer work = 500,000 extremely valuable, but wasted hours.

    How many patients could be seen with those extra hours? How many lives could be saved?



  • Brennen I think there is some truth to what you say.

    In the pre-EHR days I used to see about 50 patients in twelve hours and got out well rested and on time. I used paper notes and charts.

    In the post EHR days I saw 30 patients in 12 hours and came out 1 hour later, somewhat tired, - and my organization had excellent EHR training and support.

    The fundmental reason? Care is now EHR centric, not patient centric, and the EHR demands ever more data.... and my prediction? It’s going to get worse over the next 5 years.

    What to do? I don’t really know! But first we need to be very honest about the problem.



  • @mattrmd You're right -- The first step in fixing these problems starts with being honest and logical.

    If we see constraints limiting our output, it's not smart to add more constraints. Yet we do it every year with more regulation and bad software.

    I think we are exhibiting a major case of sunk cost fallacy in healthcare. For the most part, the $3 Trillion economy healthcare operates in has been an experiment for the past 100 years. While we're getting further off track each year, we continue the same irrational behavior because of the time, effort, & capital already sunk is the broken system.

    Sometimes we've got to wise up and cut our losses.