Primary care physicians expressed little surprise at the findings of a recent Commonwealth Fund report that determined the United States spends more than any other high-income country on healthcare, yet it has the widest gaps in the quality of the care received.
The countries that have the best outcomes on the Commonwealth Fund list—in particular, the United Kingdom, Australia, and the Netherlands—achieve their high results scores by emphasizing primary care, said Jeffrey Gold, MD, head of Gold Direct Care in Marblehead, Mass. Gold’s practice has moved to the direct care model—eliminating the insurance companies and taking a monthly fee from each patient or family for a substantial menu of routine care.
“In the U.S., primary care is nothing more than an assembly line,” he said. “I had to see twenty to twenty-five people a day, and then spend a third of my day coding. The patients were getting eight minutes with me if they were lucky. That’s why I got out. We should stop insuring primary care, and start ensuring that everyone has good primary care.”