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A cold look at expanding primary-care access

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Terence Redmond McAllister, M.D., and Leann DiDomenico McAllister push back against the idea that primary-care practices should be available to patients all the time. This leads, they argue, to clinician burnout and doesn’t help patients in the long run either.

They write:

“According to the Institute of Medicine, America’s overuse of healthcare services costs nearly $300 billion a year. And while extended and weekend hours provide ‘convenience care’ to a demanding public, extended hours have been shown to encourage patients to run to the doctor for every minor symptom they experience. Our current healthcare system trains patients to ‘feel better fast’ by running to the nearest ER with an advertised short wait time, urgent-care clinic, or buy the newest over-the-counter snake oil remedy. Contrary to popular advertising, a typical cold lasts 7 days to 10 days. It’s time we teach our patients to self-sooth.”

“Rumor has it that our quality contracts and new ACO contracts will encourage our practice to stay open longer and provide weekend hours; to be available ‘whenever’ our patients want us. We believe extended hours will increase unnecessary care which will increase costs and lead to more physician burnout.”

“Does primary care really need to be totally accessible 365 days a year, with very early and very late hours? Won’t we all sleep better and lower our burnout rate if we help our patients lower their unrealistic expectations of being ‘picked up’ {like ┬ábabies} every time they cry out?”

 

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