Take a gander at this article in Managed Healthcare Executive called Primary Care in Critical Condition but you may need some Zofran first. It starts off with some valid points about physician burnout and the problems with patients having a primary care doc:

When a 2020 Commonwealth Fund survey asked in 11 advanced Western nations how many people had a regular doctor “or place to go for care,” only Sweden ranked behind the U.S. When the question was how many had a primary care provider relationship of five years’ standing or more, Sweden slipped ahead, leaving the U.S. dead last.

So, how do we fix it? Easy…..with less care by you:

That’s not to say Bodenheimer is all doom and gloom. He’s been a hopeful evangelist for team-based care for at least 15 years. And there really should be two teams in primary care, he explains: the core teams consisting of clinicians and their medical and other kinds of assistants and the interprofessional teams that include physicians collaborating with other professionals — pharmacists, physical therapists and social workers as well as nurse practitioners and physician assistants.

With an extra medical assistant on the core team working as a scribe, says Bodenheimer, physicians can see more patients because they’re relieved of many of the documentation tasks that overwhelm their days and that they often take home to work on after a long workday is over. The nonphysician members of interprofessional teams, he says, can save physicians even more time by seeing some patients themselves “if you let them do what they’re capable of doing,” he says. Some studies have shown that pharmacists can do a better job of taking care of people with diabetes than physicians and that physical therapists can do the same for people with musculoskeletal problems, says Bodenheimer

See, it’s that easy! Don’t change the system. Leave the metrics, the insurance company demands, the prior authorizations, the government, and everything else in. Just keep adding more ingredients to the soup until it tastes like shit.

Even better, it seems like YOU ARE THE PROBLEM:

Sometimes physicians themselves are a barrier. As Bodenheimer remarked in a 2017 video interview: “Physicians are kind of crazy, in a way. On the one hand (they say), ‘I can’t do all this work; there’s too much work; I can’t stand it any longer.’ Well, you have this wonderful RN. Evidence shows that she could probably take care of half of your patients with diabetes without taking any of your time.” Here on the video he gestures frantically with both open hands, imitating the physician. “ ‘Oh, no, no, no! Can’t do that. Has to be me!’ ” Research, Bodenheimer continues, shows that nurses, pharmacists, behaviorists and physical therapists can in many cases take over some of a doctor’s workload with no compromise in quality. “Doctors have to learn how to share the care,” Bodenheimer says in the video.

Asked about this issue of the doctor’s ego, Randolph Gordon, M.D., M.P.H., is ready with an answer. “If one’s ego satisfaction is power in being an authoritarian ruler,” he says, then yes, there’s “ego diminution” when team-based care takes effect. “But,” he says, “if one enjoys working with other people, leading and learning from team members to provide better care and see better outcomes, then in my mind that’s ego enhancement.”

You and your damned ego! Forget the fact that you don’t always share the care because you are the most educated and trained to deal with issues. Oh, and you are liable for any mistakes.

The answer? Obviously more tech:

“We envision a future where medicine will be a team sport, with humans and machines working together, and consumers playing an important role,” says the Deloitte report, conjuring a future “marked by technological breakthroughs in robotics, AI, nanotechnology, quantum computing, fifth-generation wireless technologies, 3D printing and material science.” In this dizzying new world, PCPs aided by tech will be sharing more of their work with physician assistants, nurse practitioners, medical assistants and others. Physician survey respondents (not just PCPs) estimated that 30% of their current work could be performed by nonphysicians and 18% could be automated.

This is what happens when doctors lose control of the business of healthcare. The ivory tower idiots are the ones who pontificate and get all the press. Nowhere is direct primary care mentioned. We don’t need massive teams and wasteful and unproven technology! This does not mean both are bad and aren’t used in DPC. It just means that when DPC docs use a team and a certain amount of tech, they have trialed and errored it and know it works.

Please join together and fight back against these “experts” and their opinions. They don’t mention DPC because they are afraid they would have nothing to sit on the toilet and bloviate about. Direct primary care is the ONLY hope for primary care. End of story.