initially set out to write a post about lack of access to primary care
physicians, but the more I explored the topic, the more I realized that the
issue is not only that access to PCPs is limited, but that the medical model of
primary care itself has changed.
has been widely discussed among bioethicists and health care policy experts
that emergency departments are overcrowded, urgent care centers are rapidly becoming
a substitute for the traditional primary care doctor, and that the number
of new physicians specializing in primary care medicine has been declining in
favor of other, higher-paying specialties.
Still, many insurance plans require regular visits with a PCP and only
cover specialty services if the referral is made by the patient’s primary
doctor. Specialists and urgent care
clinicians also insist that patients follow up with their PCP after treatment
and make sure that their records are forwarded.
Despite the push for establishing a “medical home” and centralizing care
around the primary care physician, demand for urgent care or emergency services
is still high, and getting into a practice or getting a timely appointment with
a primary care physician is difficult.
of access to primary care is often blamed on financial issues, especially lack
of insurance, but even well-insured patients are affected by the PCP
shortage. A patient may be able to
afford the PCP visit, but they either cannot find a practice accepting new
patients or, if they are already a patient, may have to wait several days to
get a sick visit appointment.
The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.