Hugh Laurie can't do it. (We need to cut back on over testing, doctor, and those pills!...)
Marcus Welby can't do it. (Who? You mean that OLD guy?)
8% pay raise through cost shifting can't do it. (And you want me to fill out how many forms?...)
Calling their clinic a "medical home" and flooding it with angry people who can't get an appointment won't do it.
So how do you do it?
How does one go about putting the "sexy" back in primary care?
This is one of health care reform's biggest problems and right now, just about every piece of legislation promised to further overwhelm primary care doctors with more hoop-jumping than ever before. From ICD-10 with it's 150,000 billing codes, to mandates to purchase expensive medical record systems that, so far, have proven their worth to administrative collection agents in their protected silos well before they have proven their worth to our nation's health. Or to pay for performance, a form of least-common-denominator medicine that forces compliance before enabling innovation in health care efficiency. Primary care is no longer sexy, it's becoming cookbook. So much so that nurse coordinators have become the new buzzword for primary care - not exactly a reason to enter four long years of medical school and three more years of residency training. Who wants to go to school of become a doctor only to find out that you're really going to school to become a nurse manager?
And then there's the academic mega-centers' disdain for private practice care. The not-so-subtle elitist attitude that private doctors in the community aren't nearly as good as the academic megacenters' specialist care, while they, themselves, have never set foot outside their pearly gates to work in the trenches lest their white coat become soiled.
Primary care is not about medical robots, waterfall lobbies, big screen TV's and marble floors. But those things are sexy. And we all know that Americans, like bugs, are drawn to bright and shiny objects. We love the whizbang, the big buildings, the nice decor. We scream for the latest and greatest hospital additions with computer technology and the latest robots, only to turn around the next day to scream about our hospital bills. God forbid we put two and two together.
Primary care doctors are up against all of this and the marketing efforts they employ. No wonder they cannot compete.
Putting the sexy back in primary care will involve anything but more bureaucracy and oversight. Congress does not get that these aren't sexy. To them, the tombs of legislation are what's sexy ("See all the work we did?")
But what's sexy to doctors is using independence and entrepreneurism in medicine for the patient's benefit. That's sexy.
And unless our legislators get that, primary care will go the way of the dinosaurs and the great paucity of care providers imposed by bureaucratic doctrine, will continue unabated.
Addendum: Today we find that general surgeons are way ahead of primary care doctors in bringing sexy back to their profession.
It seems some are leaving the drab of emergency room call to fill SWAT teams in a "national movement" to embed medical professionals "so that help is at the ready should something go wrong."
Pitty the poor ER patient who finds the general surgeon is out on a drug bust.