Author Affiliations: Medical Service, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts.
Current primary care practice under a dysfunctional fee-for-service payment system has been likened to being on a “hamster wheel,” where many physicians find that the only way to make ends meet is to increase visit volume and perhaps add a generously reimbursed procedure (eg, skin biopsy or ultrasonography) to the office visit. As one of my patients said, “You’d get paid much more if you cut my toenails while talking to me.” Patients are unhappy, physicians are demoralized, office staff are frazzled, and applications to primary care residencies have dropped to all-time lows.1- 3
Goroll AH. When It Comes to Primary Care, More May Be MoreComment on “Encounter Frequency and Serum Glucose Level, Blood Pressure, and Cholesterol Level Control in Patients With Diabetes Mellitus”. Arch Intern Med. 2011;171(17):1550-1551. doi:10.1001/archinternmed.2011.403