US government spends more on healthcare than any other industrialized or high-income countries. But the gains from this investment is not proportionally positive. On average, Americans live shorter lives and are more likely to report a cancer diagnosis, cardiovascular disease or other chronic illnesses. One main reason among many is the average American’s ever decreasing access to primary health services.
There is a looming shortage of primary care providers in the country. Experts predict that by the year 2025, the shortage of primary care providers could become a crisis. Even now it is estimated that one in five sick people visit ER for care, they could have accessed from a primary care center.
The percentage of primary care physicians in the US is at 30%, a gradual decline from 50% five decades ago. According to experts the reason for the downwards trend can be traced to the early 40s and 50s when the general public first adopted the idea of advancement in medicine as specialization. As a result, we now have more specialists than ever before but quality of care and access to care took a hit.
Various case studies have related following problems with specialization:
1.Cost of Expertise:
Specialization adds cost to the health system which will ultimately be passed on to patients. Specialists have a greater chance of over-diagnosing a symptom and patients may be prescribed unwanted and costly treatment regimes. Experts are more likely to overuse healthcare infrastructure than a primary care physician. Many scholars now agree that psychological problems like ADHD, depression and some chronic illnesses like chronic kidney disease and some form of cancer are overdiagnosed.
2. Wrong Diagnosis:
Specialists in a field may diagnose a problem through a limited scope, in an attempt to study an issue from such conformity of their respective expertise may lead specialists to conclude the wrong diagnosis. This drawback to properly diagnose a symptom can affect patients with multiple illnesses. When the government is drawing up plans to curb the cost of treating the chronically ill, this diversified islands of thoughts and actions may not be helpful in realizing it.
3. Biases:
Specialists practicing in a field may be biased in diagnosing symptoms or cases outside their area of expertise. Such biases may lead to medical errors such as overlooking the influence of a treatment on other patient conditions, underestimating the seriousness of other health concerns. These biases may be useful in some cases but in most cases usually just adds up cost and endanger the health of patients.
Improving access to estimated 60 million Americans to primary care is not easy but necessary to ensure quality care for all. Various studies reveal primary care and income disparity are the two major influencers in life expectancy and that access to primary care also leads to improved population health parameters. Some of the major benefits of improving access to primary healthcare are below
1. Early Detection
An early detection of disease can help chances of successfully treating these diseases. Early detection is detrimental for effective treatment of some chronic diseases and conditions.
2. Efficiency
In the absence of specialization, a primary care physician will be able to observe and treat symptoms and illnesses in a holistic way making the whole process more efficient. As the whole healthcare policy is tilting away from cost per service to quality of service, the role of primary care professionals will find new importance.
3. Cost-less:
In the prevalent system, a disease is diagnosed after it has occurred. By identifying diseases at an early stage and providing holistic care primary care can cut down the cost of healthcare. Such a system can reduce the number of chronic care cases and thus remove the burden on healthcare infrastructure and also be making it available for more of the population. This will onset a positive cycle, establishing a cost-efficient healthcare system on its own.
The positive influence of primary care access to population health cannot be denied and efforts must be made to refocus attention on primary holistic care. Hope comes in the form of Accountable Care Organization and other initiatives of both federal and state governments compelling healthcare professionals to work together and improve patient outcome. Strengthened primary care may not solve the puzzle that is the US healthcare system, but it sure can be one decisive piece.
