With an estimated 25 million new people becoming insured over the next few years, a coalition of family physicians has a message for the country: Don't forget about us.
The timing is right for the group, which on Thursday announced a five-year, $20 million campaign aimed at promoting the importance of primary care. The flood of newly insured patients presents a big opportunity for primary care doctors, when you consider this: just one-third of uninsured adults said they have a regular doctor, about half the rate of the insured population, according to a 2013 Kaiser Family Foundation survey.
"Many of our colleagues have been taking care of these folks for years," said Glen Stream, a family physician who's chairman of the campaign, called "Health is Primary."
"It's now that we can give them better care. We have some catching up to do in the health of these folks who are newly insured," he said.
Managing health — and not just providing care when an illness arises — is something that the uninsured struggle with much more than the privately insured. The uninsured are less likely to get preventive care, like cancer screenings, and they are less likely to do follow-up visits after the diagnosis of a chronic condition. So the doctors see there's an educational need here, and an opportunity to reduce costs in the health-care system. That goes for all patients, though, and not just the newly insured, the doctors groups say.
Their campaign also comes at a time when there are increasingly more convenient ways to get some services usually provided in the doctor's office. Take the rise of retail clinics, for example. Though some of these clinics employ doctors or they have partnerships with local health-care systems, doctors are also skeptical about the level of care they provide. The American Academy of Family Physicians says it sees a role for these clinics, but the group warns that the settings could make it harder to coordinate care for the highest-need patients, like those with chronic conditions.
Ultimately, the groups behind the new campaign say primary care has to adapt to these changes in the health-care system, which is also moving more online.
"We want to be part of a voice that helps patients and doctors both evaluate apps — to identify those that are beneficial in providing that connection between the patient and the doctor," Stream said. "At the end of the day, if it doesn't improve health, even if it only costs 99 cents, you didn't get your money's worth."
Meanwhile, a new report issued Wednesday shows the public's trust in the medical profession has been plummeting.The big takeaway from the study: People think doctors are just watching out for themselves.
Those providing health-care services are also facing tougher demands to better coordinate care, keep patients healthier and keep down costs. This new campaign is trying to make the pitch to those who pay for care, as well as policymakers, that primary care will lead the way.
"This is just an iron-clad rule of health care — primary care provides better care at lower costs," said T.R. Reid, a former Washington Post reporter who's chronicled health-care systems around the world.
It's also a tough time to be a primary care doctor, who've seen their ranks shrink as more medical students choose lucrative specialty fields. In response, an Institute of Medicine report this summer recommended a pretty substantial overhaul of the publicly financed system for training doctors, emphasizing the need to focus on primary and preventive care.
Don Berwick, who formerly ran Medicare for the Obama administration, said primary care doctors have a limited window of time to demonstrate that they can provide better health and lower costs. Otherwise, they'll see the major payers of health care using "very blunt tools" to achieve those goals, through changing compensation and performance metrics.
"I don't think that's the preferred pathway," Berwick said. "Those entrusted with production of health care in America now have an opportunity to embrace a bigger set of goals."