The future of primary care

[Guest guest]

I posted some thoughts on the future of primary care on our blog.We are in very interesting times, both very troubling and at times exciting. describes the miserable state of independent practice in a toxic environment made more difficult by personal circumstance. Many others describe increasing administrative nonsense, a decline in the ability of patients to pay their part, and a general worsening of all that is bad in our current health care system. I expect these trends to continue and even get worse, though I also see glimmers of hope.There are small spots of good news. Brady comes pays the last bit of his startup loans and breaths easier in 2011. Larry Lindeman continues to power along doing well in spite of a high cost malpractice and overhead markets in the US.Our community helps us remember that we're not alone, that there is power in sharing information. We learn tricks in billing, new approaches to revenue, easier ways to respond to administrative trivia.As I look forward to 2011 I alternately ache and rage at status quo that so devalues the primary care our country needs now more than ever, and I have some hope that the nice words in support of our work will be backed up by changes in the policies that hurt us and our patients. The NIH is funding state level pilots of programs that are supposed to support independent small and medium practices. CMS's Center for Medicaid and Medicare Innovation has approached us because they are interested in supporting small practices and need to learn from us how to do it well. It is too early to know where we will end up by the end of 2011, but I expect that we'll see continued tension between the best of times and worst of times, and our organization will continue to grow in size and importance as others recognize the value in our work.Gordon