Fixing the Primary Care Crisis ― Reclaiming the Patient-doctor Relationship and Returning Healthcare Decisions to You and Your Doctor

In this deeply researched yet controversial book, Stephen C. Schimpff, MD breaks definitive new ground to explain why our healthcare delivery system serves us so poorly, why it costs so much, and why government and insurer policy over many decades has not only failed to improve care delivery but actually has made it worse. He then demonstrates the necessary path to convert to world class healthcare at a very reasonable cost.Primary care physicians have been forced into a non-sustainable business model that drives them to schedule an unreasonable number of patient visits per day because insurance-based payment per visit is too low. In inflation adjusted dollars, PCPs earn less today than they did forty years ago but see about twice as many patients per day. Too many visits means not enough time per patient. Not enough time means it is easier to just refer a patient to a specialist, order a test or write a prescription when some more time would have resulted in a solution to the problem and saved the need and cost of specialist, test or medication. This has led to a diminishment of care quality and a major increase in costs. This is the crisis in primary care. When primary care physicians do have time with each patient, they can offer truly outstanding care for episodic issues, effectively address complex chronic illnesses (which consume 75-85% of all medical care costs), and provide effective preventive care while maintaining health and wellness—and do so within a deep personal relationship of trust and healing. Paradoxically, primary care need not be expensive. Insurance has made it so. The time has come to allow the primary care physician the ability to care at his or her highest level of professional education and training. The result will be better care at much less cost—the major theme of this book. Dr Schimpff shows how to revitalize the patient-doctor relationship and to put decision making back into the hands of patients and their physicians. We have incredible assets in American medicine but we have failed to bring them to patients in a timely, effective, customer friendly and cost effective manner. Despite its shortcomings, American medical care delivery can be corrected. The solution is to Fix The Primary Care Crisis. The “fix” is not difficult but lack of understanding by consumers/patients and inertia by physicians stymie implementation. Patients must insist and doctors must agree to the needed changes. If we want to see better and more affordable healthcare in this country, the changes discussed in this book must be implemented. The result will be medical care delivery that is forever very different –true healthcare – both better and less expensive. This book provides the needed information, the methodology and the roadmap to Fix The Primary Care Crisis.