Total Access Medical - Direct Primary Care Blog

Primary Care Can Save America’s Hospitals

Jan 27, 2017 by William Kirkpatrick

Primary care serves as the cornerstone for building a strong healthcare system that ensures positive health outcomes and health equity. The function of primary care includes managing new health complaints that pose no immediate threat to life, managing long-term conditions and supporting the patient in deciding when referral to hospital-based services is necessary. A key aim is to keep people well, by providing a consistent point of care over the longer term, tailoring and co-ordinating care for those with multiple health care needs and supporting the patient in self-education and self-management. 

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Why Won't Supply For Primary Care Meet Demand?

Jan 04, 2017 by William Kirkpatrick

Imagine if the only place you could bring your child when he develops flu-like symptoms, an ear infection, a nagging cough, a sore throat or needs a checkup or a refill for his asthma inhaler, was to a hospital emergency room. You would be paying an exorbitant amount for basic care. But, that is what's happening today. With dropping incomes coupled with difficulties in juggling patients, soaring bills and policies from insurance companies that encourage rushed office visits all mean that more primary care doctors are retiring or leaving medicine altogether. In addition, medical malpractice lawsuits, now are common, adding more layers of paper work, expense and stress to virtually every physician’s day.

Unless immediate and comprehensive reforms are implemented by the government, primary care—the backbone of the U.S. health care system—will collapse and the repercussions will be worse than the 2008 housing crisis. Luckily, there’s still time. Primary care isn't dead yet but it is on life-support.

Here's why there are more primary care physicians leaving the medical field than entering. 

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The Consequences of Emergency Department Overuse

Jan 02, 2017 by William Kirkpatrick

Hospital emergency departments are a critical and indispensable component of the U.S. health care system which is why overuse has become a national concern and worry amongst hospitals, policy makers and healthcare providers. While their traditional mission is to provide trauma and emergency services for people in imminent danger of losing their life or suffering permanent damage to their health, the role of emergency departments has evolved over the past several decades. An increasing number of people are using hospital emergency departments for non-urgent care and for conditions that could have been treated in a primary care setting.

Why do patients seek care in the emergency department as compared to other care settings? Here are five causes of emergency department overuse:

  •   Patients have limited access to timely primary care services.

  •   The emergency department provides convenient after-hours and weekend care.

  •   The emergency department offers patients immediate reassurance about their medical conditions.

  •   Primary care providers refer patients to the emergency department.

  •  Hospitals have financial and legal obligations to treat emergency department patients.

The first four causes all relate to shortcomings in the primary care system. The rise in patient demand, fueled by an aging population and the growing burden of chronic disease, is outpacing the supply of primary care providers, which is compromising the system’s ability to deliver quality primary care services to all patients. Thus, the emergency department has increasingly filled that gap.

 

Related article: The Aging Effect on Primary Care

Related article: Why The Demand For Primary Care Physicians Outpaces Supply

 

For example, the inability of primary care practices to provide patients with timely appointments and after-hours and weekend care has driven patients to the emergency department for conditions that arise or worsen during those hours. Likewise, when patients in need of reassurance are unable to make an appointment or even speak with their primary care provider, they seek care at the emergency department.

Finally, patients also seek care in the emergency department at the explicit instruction of their primary care provider, their staff or answering service. Providers are increasingly overextended and are often unable to provide patients with same-day or even same-month appointments.

Consequences of Emergency Department Overuse

Inappropriate emergency room use creates major inefficiencies in both care and cost.

1. Crowding, long waits, and added stress on hospital resources, thereby lowering the quality of care for those with true medical emergencies.

2. Excess Costs

Emergency room use costs vastly more than its alternative. Experts estimate that the cost of an emergency department visit for a non-urgent condition is two to five times greater than the cost of receiving care in a primary care setting for the same condition.

Given cost differences and the high number of avoidable visits, it is estimated that emergency department overuse costs approximately $38 billion annually. 

Average cost of emergency department visit: $767
Average cost of office-based visit: $187
Cost difference:  $580
 

Cost Difference X (Total # of Emergency Department Visits X Percentage of Avoidable Emergency Department Visits) = National Emergency Department Overuse Costs.

$580 X (116.8 million visits X 56% avoidable Emergency Department Visits) = $38 billion

Nationally, 56%, or roughly 67 million visits, are potentially avoidable. Reducing this trend represents a signicant opportunity to improve quality and lower costs in health care. Reducing the overuse of emergency rooms will improve the care received by both urgent and non-urgent patients while cutting overall healthcare costs by billions of dollars each year.

3. Fragmented Care

A recent study found that most patients do not fully understand their emergency department care or their discharge instructions. Likewise, the health care system is poorly equipped to share patient visit information efficiently or quickly across care settings. Thus, care in the emergency department is rarely coordinated with care that occurs elsewhere in the system, including in the primary care provider’s office.

4. Overloading Hospitals’ Resources

An overload of hospitals’ resources make it harder for those with urgent conditions to receive the care they require.

5. Emergency Department Diversion

Nearly one-third of all hospitals have experienced periods of “Emergency Department Diversion,” having to divert some or all ambulances to other hospitals. In 2003, emergency room overcrowding forced half a million ambulances to be diverted; averaging one ambulance rerouted every minute.

The Solution 

Increasing access to primary care services can reduce emergency department overuse by up to 56%. A number of tested measures already exist, including offering alternative approaches to primary care, specialized services for vulnerable populations, and effective chronic disease management.

 

Related article: Direct Primary Care Saves Patients Money

Related article: Top Reasons Why Patients Love Direct Primary Care

 

But one solution stands out amongst the rest and is growing in popularity. The solution is called Direct Primary Care. Direct primary care is a newer form of concierge medicine in which patients pay a modest monthly membership fee in exchange for unlimited primary care services such as all-day access to a physician and unlimited appointment scheduling.


Are you interested in enrolling with a direct primary care practice? You're in luck. Total Access Medical is offering you the opportinity to meet for free with a physician today. 

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The Impending Healthcare Bubble

Dec 28, 2016 by William Kirkpatrick

The U.S. is in the midst of a healthcare bubble that will put the housing bubble to shame. Here's an explanation. 

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Low Physician Moral Worsens Primary Care  Shortage

Dec 21, 2016 by William Kirkpatrick

Primary care physicians are downbeat about the future of the medical profession. 

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Primary Care Physician Burnout is a Growing Epidemic

Dec 02, 2016 by William Kirkpatrick

A recent survey uncovered the truth about what doctors think about primary care and healthcare today. The survey found that 49% of primary care physicians say they "often or always" experience feelings of burnout and more than half of the physicians have considered leaving medical field altogether.

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4 Reasons Why Patients Switch To Direct Primary Care

Nov 18, 2016 by William Kirkpatrick

When you go in for a visit with your primary care doctor, do you sit in the crowded waiting room for an unannounced amount of time? Does the staff seem overworked? Does your doctor seem flustered? Is he/she rushed to move on to the next patient? Well, these are all typical complaints of today's primary care system. 

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Delaware: The Growing Demand for Direct Primary Care

Nov 09, 2016 by William Kirkpatrick

In previous blog posts I presented the projected shortfall of primary care physicians in Pennsylvania, New York and New Jersey. (Research shows that Pennsylvania will need an additional 1,039 primary care physicians by 2030, which is an 11% increase. New York will need an additional 1,220 primary care physicians by 2030, which is an 8% increase. New Jersey will need an additional 1,116 primary care physicians by 2030, which is a 17%increase). Those drastic shortages are only for three states. What's the shortfall in the rest of the country? A study estimates a shortage of 12,000 - 31,000 primary care physicians in the United States by 2025. It is more clear now than ever that the demand for primary care physician services is growing faster than supply.

Delaware

To maintain current rates of utilization, Delaware will need an additional 177 primary care physicians by 2030, which is a 27% increase compared to the state’s current 635 primary care physician workforce. The graph below projects that Delware's demand is above the overall demand in the U.S. but below the demand within the southern states. 

Pressures from a growing, aging, and an increasingly insured population create the growing demand for primary care physicians in Delaware.

The graph below shows the increased demand for primary care physicians in Delaware by 2030 is due to three factors: an aging population, a growing population, and the pressures felt from an increasing number of insured Americans due to the Affordable Care Act. 

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New York: The Growing Demand For Direct Primary Care

Nov 07, 2016 by William Kirkpatrick

In previous blog posts I detailed the current state of primary care in New Jersey and Pennsylvania. In those two states, the demand for primary care physicians is surpassing supply, leading to worry amongst government regulators and healthcare professionals. In New York, the demand isn't projected to be quite as high but the effects on consumers remains the same. 

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New Jersey: The Growing Demand For Direct Primary Care

Nov 02, 2016 by William Kirkpatrick

In the previous blog post I detailed the current state of primary care in Pennsylvania and how the demand for primary care physicians is surpassing supply, leading to worry amongst government regulators and healthcare professionals. In New Jersey; however, the demand is even steeper. 

Currently, the demand for primary care physicians in New Jersey is higher than the demand in the Northeast but lower than the demand in the U.S. overall. In the previous blog post I wrote how Pennsylvania will need an additional 1,039 primary care physicians by 2030, which is an 11% increase compared to the state’s current workforce. New Jersey, on the other hand, will need an additional 1,116 primary care physicians by 2030, which is a 17% increase compared to the state's current workforce. Primary care physicians, as evidenced by the graph below, will be in higher demand in New Jersey than in Pennsylvania for the upcoming years. 

Pressures from a growing, aging, increasingly insured population call on New Jersey to address the growing demand for primary care physicians to adequately meet health care needs. 

The graph below shows the increased demand for primary care physicians by 2030 due to three factors: an aging population, a growing population, and the pressures felt from an increasing number of insured Americans due to the Affordable Care Act. 

 

By 2020, with the number of older and insured Americans increasing, there will be a demand for 611 additional primary care physicians in New Jersey. By 2030, the number will nearly double, creating a demand for an additional 1,116 primary care physicians. 

Why is the demand for primary care physicians outpacing supply? Find out here

The Solution

To solve this primary care crisis in the United States, doctors and patients are switching to an alternative model that completely eliminates insurance and therefore, all of the problems associated with the traditional primary care payment model. This new model is called direct primary care. 

Direct Primary Care

In this alternative model, patients pay their doctor directly, rather than through their insurance company. This means that patients pay a pre-defined monthly fee directly to their doctor instead of paying insurance premiums and co-pays. Basically, direct primary care cuts out the middle man and ultimately saves patients money. The cost of care is reduced to the point where the average American can once again afford to see a physician on a regular basis. Insurance isn’t necessary within this relationship because the care is affordable. Actually, keeping insurance out is what makes this relationship functional and affordable.


Is Direct Primary Care Right For You?

For those interested, the doctors at Total Access Medical will meet with you for free to discuss more about direct primary care and it’s many benefits.

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