OnSiteClinics.Org

Staffing Concerns for the PCMH

University of Michigan researchers are publishing the results of a study they have completed in which they attempted to assess the effects of redistributing chronic disease care workload among PCPs and specialists in the patient-centered medical home model.  This model is a key component of on-site clinics, and is likewise a concept being promoted in healthcare reform.   The results of the study demonstrated that certainly the PCP is the most cost-effective and efficient way in which to address chronic illness, follow-up, wellness assessment, and preventive medicine – all of those things.

However, the study also finds that it can’t be done today (or in the near term) without a significant increase in the number of primary care physicians; having current PCPs work more hours; or specialists taking on even more of these issues (causing reduced access to specialists).

This is a huge problem for the nation as a whole.  Primary care traditionally hasn’t been attractive to residents for many reasons, not the least of which are low pay and heavy call.   Fortunately, the on-site model has recognized these problems by offering positions where the physician doesn’t have to depend on volume for income and actually has the time to do his/her job with every patient.  The model is designed and geared toward allowing the physician to do the job he/she was trained to do without financial penalty.

It has also recognized that the use of mid-level provider – who come trained with a focus on education, wellness, and preventive care – is paramount in providing the level of service that makes sense and makes an impact.  So, while other healthcare systems may struggle to find qualified PCPs, the on-site world will continue to have an advantage in the recruitment of medical professionals (at least until the PCMH truly comes of age).