The NEJM "perspectives" on primary care

I don't think of the New England Journal of Medicine as a champion of primary care, so it was nice to see that today's issue carries a section of "Perspective" articles on the future of primary care, including one by well-known family physician Thomas Bodenheimer, MD, and another by Barbara Starfield, MD, MPH, whose research in primary care has helped advance family medicine. The fact of the articles was more pleasing than their content, which basically went over the ground we've covered before – the irrational imbalance between primary care and the limited specialties in the United States, the importance of some sort of payment reform, the likelihood that the future of primary care lies in care teams, registries, population-based care, electronic medical records, and lessons we can learn from other countries.

The articles didn't offer anything new, but they might be worth scanning; they're freely available from the NEJM Web site. Bodenheimer's piece did give a concise description of what the future practice might look like, and you'll find occasional sentences that outline the problem neatly, such as Starfield's comment that "most approaches to reform do not distinguish the use of primary care services from that of specialty services, despite the underuse of the former and overuse of the latter" - a truth amply demonstrated by the recent election, in that neither party's platform recognized that reform of health care financing without reform of health care delivery fixes nothing.

Posted at 03:41PM Nov 13, 2008 by Bob Edsall  |  Comments[2]