In This Issue: Size Matters

Kurt C. Stange

doi:10.1370/afm.1895

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Response to Size Matters issue as a whole
Jean M Antonucci

Published on: 19 January 2016

Published on: (19 January 2016)
Page navigation anchor for Response to Size Matters issue as a whole
Response to Size Matters issue as a whole
Jean M Antonucci, Physician
Dr Stange and his cohorts at the Annals quietly and delightfully push and support us in primary care. A set of articles in the May /June issue critiqued NCQA's PCMH quite thoughtfully. A recent article on the paradox of family medicine, though hard to read, nailed it. Primary care produces better outcomes and lower costs despite less adherence to guidelines. Barbara Starfield said this yrs ago. Yet PCPs in Maine, as I am sur...
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Dr Stange and his cohorts at the Annals quietly and delightfully push and support us in primary care. A set of articles in the May /June issue critiqued NCQA's PCMH quite thoughtfully. A recent article on the paradox of family medicine, though hard to read, nailed it. Primary care produces better outcomes and lower costs despite less adherence to guidelines. Barbara Starfield said this yrs ago. Yet PCPs in Maine, as I am sure in many places, must prior auth COLONOSCOPIES! with one payer because last year 4% of docs disobeyed guidelines (which are apparently now law as the country desperately looks in all the wrong places for the elusive triple aim). (In fact I suggest we play Springsteen's Badlands and replace "badlands" with "guidelines" - til these guidelines start treating us good.)
I doubt that the powerful political forces will hear their duty to primary care anytime soon, but writing about small practices and large, proof of good work over form vs function, and writing proactively not endlessly chasing our tails in reactionary ways where we argue about pay then metrics then teams, may just keep us focused on the big picture long enough to keep on keeping on. We have met the enemy and he is not us. We must keep our eyes on the prize of sustainable primary care.
Competing interests: None declared
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Competing Interests: None declared.