Primary Care Has A Cinderella Moment

http://www.youtube.com/watch?v=SRt1BVa6tlU

Long the lower-paid and under-appreciated workhorse of medicine, primary care had a definite Cinderella moment yesterday at Harvard Medical School. And it seemed to hint at a whole new era to come, in which primary care stops being such a medical Rodney Dangerfield.

The scene: The first annual innovations conference at the medical school's Center for Primary Care, a new institution created with the help of a $30 million anonymous donation.

The speaker: The new provost of Harvard, Dr. Alan Garber, freshly imported from Stanford and, it just so happens, himself a primary care physician who kept practicing through his years at Stanford even as he also focused on health policy and economics.

The acoustics were hard, so here's the text of the clip above. Dr. Garber had begun by noting that it appears that national health reform is here to stay, and that it pushes medicine away from "fee for service" — payment for each procedure — and towards more global or overarching forms of payment and care.

I believe that there is no group of physicians that is better positioned to lead the efforts toward these new forms of payment, and toward surviving and thriving with the new payment requirements, than the primary care physicians.

And you can even see the recognition of this fact by the specialties, many of whom are clamoring, for example, to be designated as patient-centered medical homes.

So it’s an unfamiliar situation for many of us who’ve been in primary care for some time. We have to seize this opportunity.

And one of the reasons why I’m so excited by this event today is the focus on innovation and what I believe....is the right direction for primary care to go in.

We are being put in a position where we are going to be responsible for truly managing care. And I use that term, 'managing care,' with some trepidation, because for many people that will bring to mind the so-called managed-care era. And it’s ironic because of course, in most 'managed care' plans there was almost no management, at least not at a clinical level.

We have much better tools today, and we have much better capabilities.