Over 90% of our members advocate for our care, our costs are lower than competitors, quality scores are best in class, hospitalization and ER rates are low. Appointments are 2-3 times as long, panels 1/3 the size, support teams 2-3 times as large and unmeasurably more empowered to care for members. I now work for a primary care focused medical group that leads with relationship based care. Service was poor, burnout was high, and we were unable to control hospital and specialty costs. I was constantly in a hurry and never felt I was able to provide the highest level of care that members deserve. We had less than one team member per doctor (1/2 of an MA, 1/4 of an LPN, 1/8 of an RN), very large panels, inadequate time with each patient (20 minutes for a hospital follow up or new patient, regardless of age). Yet primary care made up less than 1/3 of the physician workforce and provided over half of outpatient visits. I spent 14 years in an excellent integrated health care system providing best in market primary care. What would care in the US look like if patients had access to empowered primary care teams with adequate time, training and resources to proactively manage complex care? You make an excellent point that these results are given access to sorely underfunded primary care teams with very little support. 4 In a landmark international study, Starfield and colleagues 5 found that where primary care is available, per capita costs are lower, health status is better, and health disparities are fewer. 2 The underfunding of US primary care has been suggested as one of the principal causes of the poor performance by our health care delivery system. 1 - 3 This is not the case in the United States, where primary care accounts for only 7% of total health care spending and specialists outnumber primary care doctors by a ratio of 2 to 3:1, 3 resulting in the worldвЂ™s highest per capita health care costs and subpar population health status.

1 They spend about 20% of their total health care dollars on primary care, support a 1:1 ratio of specialists to primary care physicians, and rank among the highest in population health status while keeping per capita health care costs relatively modest. Most advanced nations, such as those belonging to the Organisation for Economic Co-operation and Development, recognize and fully finance the central role of primary care in their health care delivery systems.

Goroll primary care medicine reference