One Less Primary Care Doctor

Jacob Goldstein
http://blogs.wsj.com/

“I have had three different primary care doctors over the past 10 years,� said Mrs. J. “You can’t leave now. I was just starting to feel comfortable. I am getting older now. I can’t keep changing doctors!�

Today’s primary care lament comes to us via a Boston Globe op ed by Annie Brewster, who left primary care after only a few years and now works as an urgent care doc at Mass General.

Like most of the laments we’ve been reading lately, the piece talks about how primary care docs are “drowning,� overwhelmed by endless days of back-to-back, brief patient encounters. Brewster’s suggestions for change are pretty standard — pay more for things like communication and care coordination, and reward doctors for keeping patients healthy.

But, as the tale of Mrs. J suggests, the op-ed also connects the frustrations of primary care doctors with the frustrations and fears of primary care patients. “I am most troubled by the antagonistic state of the patient-doctor relationship,� Brewster writes. “The system sets us against each other.�

She describes walking into an exam room and introducing herself to a patient — only to be told by the patient that they had met before. “Patients are angry,� she writes, describing the impersonal treatment, long waits, rushed visits and lacking follow-up that are typical elements of a trip to the doctor. “We are not offering high-quality care.�

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