It's tragic that primary care docs don't understand that 3rd party payer domination of U.S. health care is a major cause of their problem. Anything that disrupts that equilibrium, such as convenience clinics, is good for primary care docs too.

As long as they are dependent on 3rd party payers, primary care docs will always "lose" versus specialists, because the 3rd party payer cannot observe what the primary doc does, whereas the cardiac surgeon can say "I did a quadruple bypass" and it's not difficult for the 3rd party to confirm.

Uncertainty causes reduced payment. Even less fortunate, Baumol's hypothesis is likely relevant to primary care docs: because they are "cognitive", it is very unlikely that they can increase their "productivity", like, e.g., cardiac surgeons can through experience and new technology.

Because the "cognitive" skills of primary care that reduce "productivity" are "soft", the 3rd party payer will not value them as much as the patient.

So why aren't more primary care docs on our side?!?!?

• posted by John R. Graham
• August 20, 2007 @ 3:39 pm
• Permalink

Post Your Comment Here

Name		*
E-mail		*
Response		*
Enter the characters as they appear in the box to the right		*
		* = Required field