More Comprehensive Care Among Family Physicians is Associated with Lower Costs and Fewer Hospitalizations

I couldn't be happier to see this publication at this time. This "large data set" analysis confirms multiple examples now being cataloged by the Patient-Centered Primary Care Collaborative (PCPCC) that comprehensive primary care is the way this nation can achieve the Triple Aim of better health and better care at less cost. Yes, there are caveats and possible specific populations where the impact is not linear in benefit, but we all know that a "one size fits all" approach is never the full solution. The direction is clear, however, and with a bit more detail to the analysis, the most impactful components can be identified.

In addition, the timing of this couldn't be better. The "Family Medicine for America's Health" project is still debating how to define the scope of practice of family physicians for the future. This publication will inform that debate with tangible data.

Finally, Dr. Chen's final comment is the key to finally making a difference in this nation's health. If the payment systems won't support comprehensive care with appropriate financial incentives, the true benefits of that care will never be fully realized. So, the real challenge to improving health in the U.S. is squarely at the feet of the payers (federal, state and commercial). The question is, "Will they respond?"

Competing interests: None declared

Let's not get too carried away here! Rather than reigniting scope of practice debates AMONG family physicians, or BETWEEN family medicine and other primary care specialties, remember that primary care, ANY primary care, is better than the heavily specialty-centric mix of uncoordinated, uncomprehensive care that most patients currently endure.

I applaud the authors for shedding much needed light on comprehensiveness of care, but don't let it detract from the need at hand - more family physicians are what we need to achieve the Triple Aim. I'll take an outpatient-only family doctor over a dermatologist any day!

Competing interests: None declared