Still Unresolved: How We Pay Physicians, And The Primary Care Crisis

Wednesday’s news that physicians had, yet again, dodged the Sustainable Growth Rate (SGR) pay cut bullet – if you access the AMA article linked to above, be sure to read to the end to see how this new cost will be paid for – reminded me of Ursula Buendia’s observation in Gabriel Garcia Marquez’ great One Hundred Years of Solitude that “Time is going in a circle.”

Almost exactly three years ago, Congress provided the same last minute reprieve, and also after great drama. Now the AMA and Mr. Obama have announced their intention to fix the SGR, replacing it with a different approach. It will be interesting to see the proposals that emerge after the New Year.

At the time, that event provoked me to write a fairly long diatribe against the machinery that created the primary care crisis and that, I will add in retrospect, has been a principal driver of the larger health care cost crisis.  The piece below, Bad Medicine: How the AMA Undermined Primary Care in America, remains relevant because the problems, still unresolved, have only worsened.

Dr. Kibbe and I will have a new piece coming out soon that suggests a course of action on this issue.

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