A new study published in the New England Journal of Medicine by Dr. Richard Baron outlines the invisible burden of disease for family doctors.
What does this mean?
Insurers only reimburse primary care providers for patient visits. In his study, Dr. Baron quantifies the variety of unreimbursed tasks, including making phone calls, reading and writing emails, writing prescriptions, reviewing x-rays, and examining lab reports, that burden primary care providers. Essentially, the study documents the large amount of invisible work required in primary care.
What can be done?
Dr. Baron explains that the study shows the need for new types of payment that reimburse primary care providers for the amount of care they provide. “Baron acknowledged that reimbursing for each phone call or e-mail a physician handles would be impractical, but he suggested that adopting capitation — in which physicians would receive an annual lump sum per patient — would better cover the amount of time primary care physicians actually spend on patients” (Rubin, USA Today, 4/29).
Other experts suggest that electronic health records can improve care coordination and efficiency reducing burdens on providers. Dr. David Blumenthal, the Obama administration’s National Coordinator for Health IT, said the study shows “the enormous strain” on primary care doctors but also show “a pathway toward escaping at least some of those burdens; the electronic health record combined with changes in work flow and payment” (Lohr, New York Times, 4/28).
