One of Dr Katz's suggestions why primary care physicians' referral rates have almost doubled in the past decade—namely, that they are pressured to do too much in too little time1—merits further discussion. Having practiced primary care for 36 years, I have seen many changes, but the single most definitive one is that my administrative-coordinative role has almost surpassed the actual medical care I give. And, the “medical home” currently being touted will place more administrative-coordinative demands on primary care physicians. Why? Because other members of the health team will always find excuses to use it as a repository for any paperwork that they do not want to deal with.
Volpintesta EJ. A New Paradigm for Primary Care. Arch Intern Med. 2012;172(11):894. doi:10.1001/archinternmed.2012.1058
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