Practice under Pressure: Primary Care Physicians and Their Medicine in the Twenty-First Century

By Timothy Hoff | Go to book overview

Chapter 1
The Transformation of Primary Care
in the United States

Primary care is undergoing profound change in the United States. This is evident in a sicker general population, a decreasing supply of doctors to care for that population, new alternatives to the traditional primary care physician and practice, and an economic model of primary care delivery that creates dissatisfied doctors and patients. Everyone from professional associations to the government believes that money is at the root of the problem. Primary care doctors get paid much less than other doctors, and primary care services are not valued in the same way by third-party payers as specialty services.

Money is only part of the problem. Focusing only on better reimbursement or salaries, as most solutions to the primary care crisis currently do, obscures the impact of an evolving primary care workforce, the negative effects of a reduced scope of work in primary care, and poorly designed primary care training that renders the field unattractive to aspiring doctors. Indeed, the field of primary care has contributed to its own continuing demise, handing over more sophisticated work like hospital medicine to others with little but a whimper. Primary care physicians play to financial incentives that produce eight-hour work days of seeing patients in the office on a nonstop assembly line. Increasing numbers of them want a nine-to-five job and more free time on nights and weekends. At the same time, they hope for patient compliance and loyalty while acknowledging diminished expectations of their own roles as professional caretakers.

The field of primary care now proposes a solution like the “medical home” concept to provide higher reimbursements and prestige for the field. This approach involves emphasizing the patient perspective more in delivering care.

-1-

Notes for this page

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items
Notes
Cite this page

Cited page

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Note: primary sources have slightly different requirements for citation. Please see these guidelines for more information.

Cited page

Bookmark this page
Practice under Pressure: Primary Care Physicians and Their Medicine in the Twenty-First Century
Table of contents

Table of contents

Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this book

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen
Items saved from this book
  • Bookmarks
  • Highlights & Notes
  • Citations
/ 238

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Search by... Author
    Show... All Results Primary Sources Peer-reviewed

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.