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- Page navigation anchor for RE: Dr Bodenheimer's reflectionsRE: Dr Bodenheimer's reflections
Sadly, Dr B is wrong. Panel size, payment and teams will not fix primary care.
We need functional unified EMRs, and changes in policy and in the culture that are unlikely.
Dr B wasn't wrong when he co-wrote Improving Primary Care. In that book was the case of a woman with breast cancer who was referred out and hopelessly lost in the system. My first EMR would have tracked her so I could follow up. My current EMR sends patients to a faraway “access center "where some MA finds patients some place to be seen, and care coordination is impossible. My first EMR did not meet MU -what is the message we send to PCPs? We need one EMR that has basic functional features.It is not money, it is how hard it is to get it. Coding for billing games, clearing houses and scrubbing, begging to be paid, costing us thousands of dollars.
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RI did get more money but little trickled down to primary care, most lost in administrative bloat. The sparkling gems of RI micropractices with their small panel size and house calls to new mothers are all gone but for one who does MAT.
What is wrong and is unlikely to be fixed is our culture with our legislators and their lobbyist bedmates, as well as hospital behavior-one cannot order a test unless it is inserted in their system -which one is not allowed to access; insurers’ policies forcing PCPs to stop work, reduce access and write the referrals f or XRT that were made by surgeons for that woman with breast cancer- s...Competing Interests: None declared.