The ills of our primary care system are spreading
Primary care providers are chronically undervalued
Re “Despite need, primary care harder to find: Fed up with administrative tasks, doctors moving on” (Page A1, March 14): Felice J. Freyer appropriately notes that doctors say “the system doesn’t support the essence of primary care, which involves preventing illness and managing chronic conditions,” and instead insurance pays more for procedures.
Besides lower salaries, this chronic undervaluation of primary care and lower reimbursement lead to lower investment and support for primary care practices at our hospitals and multispecialty clinics. Were the revenue streams greater for primary care services, the administrative burdens Freyer identifies — entering data into electronic medical records and obtaining prior authorization for tests and medications — could be more easily managed by nonclinical staff. The lack of such support burdens physicians, physician assistants, and nurse practitioners with a mountain of extra work outside of patient care hours, which in turn makes the primary care role unappealing for many providers.
The MassHealth initiative to pay a set fee per patient rather than by visit or procedure and the state’s plan to infuse an additional $115 million into primary care per year for MassHealth patients are a good start. But until Medicare, MassHealth, and private insurers meaningfully place a higher value on primary care services, the yawning gap between the number of patients needing care and available providers will only grow larger.
DR. GREG SCHWARTZ Newton
The writer has been a primary care physician for nearly 25 years at Mass General Brigham.