How primary care is being held hostage to tertiary care

Illustration by Jorge Muniz, PA-C. Here’s a quick review of health care delivery basics: Primary care. Stuff you can get handled with your primary care doctor in your neighborhood. Example: ingrown toenail. Secondary care. Stuff your primary care doctor refers to a secondary specialist down the road. Example: colonoscopy. Tertiary care. Complex stuff you need to deal with at a big-city hospital. Example: lung transplant. Simple. Right? Here’s the problem: In modern medicine, we’re holding primary care hostage to a tertiary care delivery model. If you’re getting a lung transplant, you need a 5-story hospital with helipad, medical team, insurance coding/billing software (you actually need insurance to cover the $500,000+ bill) and all sorts of special machines and complicated equipment. If you’re getting a colonoscopy, you need one person to shove a tube up your butt in a simple office with a few staff. If you’ve got an ingrown toenail, you need one primary care doc in one tiny exam room with a pair of scissors. When we force ingrown toenails and buttholes to subsidize 5-story hospitals, helipads, medical teams, and insurance systems, we create incredible inefficiency and expense. In fact, all that crap is not only unnecessary, it just gets in the way and makes your $100 toenail or $1000 colonoscopy cost hundreds and thousands more! When we force primary care to pay for the infrastructure of tertiary care medicine, we end up with assembly-line medicine in which pa...
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Physician Primary care Source Type: blogs