Created on 2017-04-28 04:55
Published on 2017-04-28 05:04
No healthcare discussion is complete without all of us tom-tom-ing the importance of primary healthcare and then we go back doing business as usual – ie specialized secondary and tertiary care.
What gives?
Increased focus on specialization in medical education and employment
A classic chicken or egg situation. Doctors want to specialize because that is where opportunities are. Clients are seeking specialists because that is where the good doctors are. Unless general practitioners become the custodians of care in our communities this problem will continue. Unless, we bypass this problem altogether and focus on the next issue
Doctors as providers of primary care is overkill
There is enough evidence to show that nurse practitioners and physician assistants can deliver the same level of primary care when adequately trained. So instead of focusing on 600k doctors who are any way in short supply, why not focus on the 1.2 million paramedical workers who can be upskilled as primary care providers
Misalignment of incentives
Does the primary care provider, client, the payor (employer, insurance provider or government) and the hospital have the right incentives for prioritizing primary care. Are the incentives aligned not only in the favour of the client, but also everyone? Adequate compensation of primary care providers, insurance reimbursement or coverage of primary care, regulatory checks etc would be some of the incentives.
Focus on Institutional primary care
Do we have to provide primary care in a clinic? With technology improving and established models of home healthcare, why not look outside and provide care where the clients are – our schools, companies, factories and other public spaces of high population density.
Archaic models built for the curative world
Healthcare insurance has focused traditionally on covering catastrophic illness via insuring against major illnesses. What models can support non-catastrophic routine primary care while not burdening them. A combination of public funded + insured model, perhaps? Is there an opportunity to rethink health insurance and healthcare payments from the ground up, from the lense of primary care
Would love to get your comments and host a webinar on this topic soon.
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If you liked this post, you might be interested in my other posts: Hospitals, a historical perspective and relevance for the future, You are not the Unicorn, You are Awesome, Shoot me if I ever say these things to a startup team, The Doctor is NOT in, the Doctor will see you NOW, and Davos Learnings for my Daugther.
About Ashwin Naik
Ashwin Naik is an entrepreneur with interest in affordable healthcare, social enterprise and healthcare technology. You can also visit his blog to read more.
Ashwin has been recognized as a Economic Times Leaders under 40, Young Global Leader By World Economic Forum, Young Leader by Asia Society, Senior Ashoka Fellow & as a Ted Fellow.