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Primary care is a hot topic these days. 

Primary care physicians are frustrated by overwhelming patient loads and the associated paperwork, lowered esteem within the medical community, and a continued decline of medical students willing to join their ranks.

Is it about the money? Will the “patient centered medical home” improve the reimbursement for managing patients’ care and create enough cost savings to improve the financial lot of the primary care physician? Will advanced degree nurses, physician’s assistants, pharmacists and physical therapists be needed to support those physicians who continue to practice primary care?

It did not happen with the “gatekeeper” managed care model of the ’80s, so there’s at least cause to be skeptical.

In an editorial written by Emily Friedman , I think she correctly views the physician as a linchpin required to hold it all together.

A linchpin is defined as something that “serves to hold together the elements of a complex.[5]” If there are not enough — or any — primary care physicians, the question is obvious: Who’s going to hold it all together?

Without the linchpin will healthcare costs be driven by patients’ self referral to specialists, similar to increased lay prescription requests advanced by direct-to-the-public pharmaceutical advertising?  Healthcare professionals need to have a greater means of being reimbursed for their knowledge so we can effectively help administer and direct effective care, not just prescribe pills and perform procedures. 

Maybe the primary care role will gain a new life if its acknowledgement as the linchpin within the healthcare industry reaches widespread adoption.  Only time will tell.