Fixing the Primary Care Crisis: Reclaiming the Patient-Doctor Relationship and Returning Healthcare Decisions to You and Your Doctor, by Stephen C. Schimpff MD FACP
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Fixing the Primary Care Crisis: Reclaiming the Patient-Doctor Relationship and Returning Healthcare Decisions to You and Your Doctor, by Stephen C. Schimpff MD FACP
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In this deeply researched yet controversial book, Stephen C. Schimpff, MD breaks definitive new ground to explain why our healthcare delivery system serves us so poorly, why it costs so much, and why government and insurer policy over many decades has not only failed to improve care delivery but actually has made it worse. He then demonstrates the necessary path to convert to world class healthcare at a very reasonable cost. Primary care physicians have been forced into a nonsustaining business model that drives them to schedule an unreasonable number of patient visits per day because insurance-based payment per visit is too low. In inflation adjusted dollars, PCPs earn less today than they did forty years ago but see about twice as many patients per day. Too many visits means not enough time per patient. Not enough time means it is easier to just refer a patient to a specialist, order a test or write a prescription when some more time would have resulted in a solution to the problem and saved the need and cost of specialist, test or medication. This has led to a diminished level of care quality and a major increase in costs. This is the crisis in primary care. When primary care physicians do have time with each patient, they can offer truly outstanding care for episodic issues, effectively address complex chronic illnesses (which consume 75-85% of all medical care costs), and provide effective preventive care while maintaining health and wellness—and do so within a deep personal relationship of trust and healing. Paradoxically, primary care need not be expensive. Insurance has made it so. The time has come to allow the primary care physician the ability to care at his or her highest level of professional education and training. The result will be better care at much less cost—the major theme of this book. Dr Schimpff shows how to revitalize the patient-doctor relationship and to put decision making back into the hands of patients and their physicians. We have incredible assets in American medicine but we have failed to bring them to patients in a timely, effective, customer friendly and cost effective manner. Despite its shortcomings, American medical care delivery can be corrected. The solution is Fixing The Primary Care Crisis. The “fix” is not difficult but lack of understanding by consumers/patients and inertia by physicians stymie implementation. Patients must insist on, and doctors must agree to, the needed changes. If we want to see better and more affordable healthcare in this country, the changes discussed in this book must be implemented. The result will be medical care delivery that is forever very different –true healthcare – both better and less expensive. This book provides the needed information, the methodology and the roadmap to Fixing The Primary Care Crisis.
Fixing the Primary Care Crisis: Reclaiming the Patient-Doctor Relationship and Returning Healthcare Decisions to You and Your Doctor, by Stephen C. Schimpff MD FACP- Amazon Sales Rank: #157538 in eBooks
- Published on: 2015-05-07
- Released on: 2015-05-07
- Format: Kindle eBook
Review
"Steve Schimpff has written an outstanding treatise describing how misdirected attempts to save money have underfunded primary care resulting in lower quality healthcare, an increasing shortage of primary care physicians, and an increase in the cost of healthcare. He shows how a change in the healthcare paradigm can lead to better care at lower cost that is more rewarding to patient and physician." —Robert J Alpern, MD Ensign Professor of Medicine and Dean, Yale School of Medicine
“With nearly 3000 employees, the health of our company depends on a healthy workforce. We deliver highly-advanced technical and engineering services, so illnesses, as well as the cost and quality of healthcare available to our employees, directly impact our productivity and customer satisfaction. Fixing the Primary Care Crisis brings attention to an issue that will resonate with businesses of every size, in any market.”—Bahman Atefi, ScD, CEO, Alion Science and Technology
“Dr. Schimpff eloquently illustrates one of the principle lessons we teach our medical students throughout their training: relationship matters. He rightly asks how the doctor-patient relationship has suffered in today’s medical/commerce environment. Dr. Schimpff’s powerful patient vignettes and wide ranging interviews provide thought provoking concerns for physicians, patients and those of us whose mission is to train the next generation of healthcare providers.” —Robert A. Barish, MD MBA, Chancellor, LSU Health Sciences Center, Shreveport
“Fixing the Primary Care Crisis is an outstanding work by an extraordinary writer. As in his previous works, Dr. Schimpff has clearly identified the issue in a manner for all to understand. The crisis is real and imminent and we would all be served in heeding Steve’s advice.” —Stephen Burch, Chairman of the Board, University of Maryland Medical System, former president, Atlantic Division, Comcast Inc. and retired CEO, Virgin Media UK
“As with the other topics in medicine he has so carefully analyzed, Dr. Schimpff presents a thoughtful and insightful discussion of contemporary primary care medicine. Patients and doctors will understand his clear exposition very useful.”—William L. Henrich, MD, MACP, President and Professor of Medicine, The University of Texas Health Science Center at San Antonio, Texas
Stephen Schimpff, MD provides a uniquely qualified view on the future of health care, with a focus on primary care medicine and the physician-patient relationship in the post-reform era. As a highly esteemed physician, academic leader, health system executive, and national thought leader on clinical issues, Dr. Schimpff paints a picture of an industry that is experiencing real change due to an overwhelming convergence of interests, incentives and macro-environmental forces disrupting primary care. At a time when patient-centered care is a growing, talked-about movement, Dr. Schimpff eloquently defines the problem and offers intelligent, actionable solutions to activate primary care innovation.—Don McDaniel, President and CEO, Sage Growth Partners
“A must read for all health professionals and policy makers in addition to patients and doctors. Dr. Schimpff doesn’t just lay out the problems with our health care system. His experience and research cite both provider, payer and consumer steps which must be taken to make the United States healthcare system affordable and of higher quality.”—Michael R. Merson, MBA, retired president of MedStar Health, former CEO, Helix Health System and former board chair, Carefirst BlueCross BlueShield, Inc.
“Dr. Schimpff makes an urgent case for a transformed healthcare system based on proactive primary care, wellness programs, early treatment of chronic conditions, and plenty of time for physician/patient visits. We’ve seen the results with our QuadMed primary care model: a healthier, more productive workforce and greater control over total health care costs. This book offers powerful solutions for every employer.”
—Joel Quadracci, Chairman, President & CEO, Quad/GraphicsAbout the Author Stephen C. Schimpff, MD FACP is an internist, researcher, professor of medicine and public policy, former University of Maryland Greenebaum Cancer Center director and former University of Maryland Medical Center chief executive officer. He is a graduate of Rutgers University and Yale School of Medicine. He is board certified in internal medicine, medical oncology and infectious diseases. Most of his career was spent at the National Cancer Institute, the University of Maryland Medical School and the University of Maryland Medical System. Since quasi-retirement he has authored four books for the general public on medical topics. He and Carol, his wife of over 50 years, live in Maryland. Learn more about Dr. Schimpff’s books, articles and blog at: www.medicalmegatrends.com
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Most helpful customer reviews
2 of 2 people found the following review helpful. A milestone in America's healthcare reform thinking By NJS This is a major contribution which offers a turning point in healthcare discussion. As a clear, authoritative, state-of-the-art orientation text in one of America’s most important current public interest issues, it is a milestone in America's healthcare reform thinking which every US presidential candidate should read.This statement may sound extravagant, but I offer it with due consideration, for three reasons. The first is Schimpff’s credentials. Unlike many writers on healthcare and other public policy issues, he has no agenda apart from wanting to help improve healthcare. He’s not running for public office or seeking to climb a professional ladder. His long and successful career has spanned medical practice, teaching, research, advising government, and successfully running one of the world’s leading hospitals. Although he retains professor status in medicine and public policy, he’s essentially retired to his study to document and analyze the state of healthcare as he sees it. He has nothing to prove to anyone and no one to cozy up to politically. This is fortunate for the rest of us, because his mind contains a unique encyclopedia about how healthcare works and how it can be changed to serve us all better. Schimpff isn’t just another commentator. He’s a national resource.The second reason to pay attention to Schimpff is his tone. Despite its context of crisis it is patient and calmly reasoned, marked by a note of urgency derived not from hysteria but from moral earnestness. He is convinced that we must fix the healthcare system not just because doing so will be economically efficient but because it will be ethically right. Both this conviction and the nature of the solutions he offers enable his suggestions to achieve unusual success in bridging the ever-widening intellectual gap that has grown between the moral and politico-economic perspectives on medical services. It’s this blend of moral and economic message that gives his book its philosophical importance.The third reason to read this book is that unlike many discussions of big ideas it doesn’t leave it to others to cope with the details. Because Schimpff has been responsible for making medical services work on every level of policymaking and administration, he knows the circumstances in which doctors work most productively, both individually and in collectives.The word “crisis” has become so commonly used that its meaning has been debased, but the primary care issue really is one. Of all the aspects of healthcare policy that need attention, this one -- the lack of access of millions of Americans to a doctor with whom they can develop and sustain an ongoing health-monitoring and advisory relationship – is arguably the most pressing. It isn’t a crisis only for patients, but also for government, for all the institutions that support healthcare, for physicians themselves, and for the economy as a whole. Schimpff’s book reflects a keen grasp of this interlocking nature of the healthcare ecology, which is like a biosystem in which damage to one part can impair the functioning of a multifaceted whole. Schimpff has grasped a key fact, namely that the economics of healthcare cannot be fixed by accountants and economists alone. There must be a fundamental philosophical change in how we approach healthcare. It is widely believed that the crisis in healthcare is the result of the great expense of the necessary services, but as Schimpff shows, the crisis has not been caused by the expense; the expense has been caused by the crisis. This stems from the way our medical establishment is structured, and it can be fixed. Read this book for a fresh understanding of both the problem and the road ahead.N.J. SlabbertThe above is based on a fuller article which can be read here http://www.thearisinstitute.com/publications/
2 of 2 people found the following review helpful. Fixing the Primary Care crisis is truly insightful and inspiring; further, it brings back hope to this once sacred profession. By Jonathon Izbicki, DO There is a growing crisis occurring nationwide among Primary Care physicians. This crisis is one of awareness in this area, and Dr. Schimpff is to be credited for his efforts in making a difference to patients and to their physicians by giving them hope for a healthier and happier tomorrow by how they receive and deliver their healthcare at the primary care level.Fixing the Primary Care crisis is truly insightful and inspiring; further, it brings back hope to this once sacred profession. Primary Care is of the utmost importance, as it is the foundation of a healthier America. Dr. Schimpff does an exemplary job explaining how Primary Care has been devalued by the middlemen – the health insurance companies, leading to rushed and hurried visits – cattle drive medicine, where time and quality isn’t valued, but rather, overbooking schedules to maximize the number of patients (units) seen per day is where the value lies. This metric is clearly wrong and leads to the negative perception of care which has caused further deterioration of the sacred trust between patients and physicians.Over the last 30 years, health insurance companies and the government have been adding bureaucracy and red tape to health care at log rhythmic rate which is at the very crux of eroding the patient-physician relationship, leaving the majority not really knowing who is to blame. Often the physicians are placed in the cross hairs due to all the propaganda created by aforementioned entities; and are often silent, as the altruism card is used against them. As a result of the process, many Primary Care physicians have or are dangerously close to becoming indifferent and full of despair as they are burning out from the cattle drive or hamster wheel of medicine.It is no secret that this great nation is going through a lot of struggles and adjustments in the area of health care. We are all part of that struggle – each and every one of us. An ounce of prevention is worth a pound of cure. Dr. Schimpff explores and explains the various models that have emerged, as physicians are attempting to find a way to survive and to honor their sacred oaths. A growing number of Primary Care physicians nationwide, like my brother and me at Izbicki Family Medicine, are saying no more, and are starting Direct Primary Care practices. As Dr. Schimpff explains, DPC practices are revitalizing Primary Care by focusing on restoring the patient-physician relationship. Direct Primary Care very much is a cost-effective solution that is a win-win for both the patient and the physician. It’s a solution that is physician led for the people and by the people. It gives physicians their voices back to practice medicine the way it was always intended to be practiced. Dr. Schimpff believes, as do we, that Direct Primary Care will be the salient model for Primary Care for the future.Dr. Jon Izbicki, DO, Izbicki Family Medicine | Direct Primary Care, Erie, PA.
1 of 1 people found the following review helpful. Finally some innovative approaches for delivery of an effective, ethical, compassionate healthcare system in the U.S. By Debo Frost Pontification on the inadequacies of the American health care system seems to be a popular pastime for the self-proclaimed experts (on everything) who are so abundant in United States today. There are so many targets for blame: doctors, nurses, hospitals, pharmaceutical companies, insurance companies, fast food chains, advertisers, politicians, the government-anybody and everybody who stands to profit from the unhealthiness of people. And the recipients of the ineffective healthcare are also blamed for the failure to resist the temptations that prevent them from leading a healthy lifestyle. It is easy to blame, and while it is important to acknowledge the existence of problems, just pointing fingers, especially semi-knowledgeable ones, does not fix the problem.“Fixing the Primary Care Crisis: Reclaiming the Patient-Doctor Relationship and Returning Healthcare Decisions to You and Your Doctor” distinguishes itself from all that noise and bluster. Dr. Schimpff has done extensive, meticulous research and compilation of existing data and information. Applying his extensive breadth and depth of experience in the health care field, he has analyzed these data to identify and validate the root causes for the healthcare system shortcomings. With this comprehensive understanding of the causes, Dr. Schimpff presents innovative and intriguing new approaches for an effective, ethical, and compassionate healthcare delivery system for the U.S. Some of these approaches are already in early pilot stages, and Dr. Schimpff provides a detailed analysis of their effectiveness to date. The content of the book is intelligently communicated in a clear and comprehensive manner that is easy to follow, and that is accompanied by numerous highly relevant examples.Dr. Schimpff has a clear passion for delivering effective, ethical, compassionate healthcare to everyone. I highly recommend this book to anyone who is interested in effective and innovative solutions to our healthcare delivery challenges.
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