Top-Down Demands on Primary Care Creating Medical Populism in Response to Burnout, AJMC® Commentary Says
December 06 2018 - 1:35PM
Business Wire
The forces leading to detachment and depersonalization among
burned-out primary care physicians are similar to the factors
responsible for populist movements—the perception of a rigged
system favoring a managerial elite, according to a commentary in
the December issue of The American Journal of Managed Care. ®
In a thought-provoking commentary in the current issue of The
American Journal of Managed Care® (AJMC®), a family physician draws
parallels between populist movements in society and physician
burnout in primary care and warns that the failure of healthcare
leaders to recognize the systematic issues facing the profession
portends a worsening shortage of primary care doctors.
James O. Breen, MD, a board-certified family medicine
practitioner with Lee Physician Group in Fort Myers, Florida,
writes frankly about the anger felt by physicians as they grapple
with an ever-increasing set of regulatory burdens, obsession with
quality metrics, and struggles with reimbursement imposed from the
top of the medical elite—governmental payers, agencies, state
medical boards, legislators, and medical associations.
Comparing the frustration felt by doctors with that of people
who feel that they are not being heard by their government, Breen
notes that populist movements, whether they are disparaged or
commended, are based on sharp distinctions between “everyday
people” and “elites.”
“The perception of corruption, opacity, and technocratic
complexity leads adherents to challenge a rigged system tilted in
favor of those who make the rules at the expense of everyone else.
This alienation thus undermines the legitimacy of established
institutions of governance and order,” he writes in the commentary,
“Primary Care Burnout and Populist Discontent.”
One signal of this discontent, Breen says, is growing interest
in an alternative payment model called direct primary care (DPC),
in which providers forgo insurance arrangements in favor of monthly
payments from patients, with whom they can then spend more time.
(DPC is different from concierge practices, which may still bill
insurance companies in addition to collecting fees from patients
for an enhanced level of service.)
By rebuffing all payers, DPC physicians also remove themselves
from some administrative burdens, Breen notes.
Failure of healthcare leaders to do more than tweak work
environments with stress-relief initiatives or similar marginal
efforts to tackle burnout will only fuel the growing discontent
among primary care doctors, who may in turn remove themselves from
the established medical system by continuing to set up DPC
arrangements, create alternatives, or seek early retirement, Breen
warns.
For more information, visit www.ajmc.com.
About The American Journal of Managed
Care®
The American Journal of Managed Care® (AJMC®) is a
peer-reviewed, Medline-indexed journal that keeps readers on the
forefront of health policy by publishing research relevant to
industry decision makers as they work to promote the efficient
delivery of high-quality care. AJMC.com is the essential website
for managed care professionals, distributing industry updates daily
to leading stakeholders. Other titles in the AJMC® family include
The American Journal of Accountable Care® and two evidence-based
series, Evidence-Based Oncology™ and Evidence-Based Diabetes
Management™. These comprehensive offerings bring together
stakeholder views from payers, providers, policymakers and other
industry leaders in managed care. To order reprints of
articles appearing in AJMC® publications, please contact Gil
Hernandez at 609-716-7777, ext. 139.
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AJMC® Media ContactsAlexandra Ventura,
609-716-7777, ext. 121aventura@mjhassoc.com
John Patricolo, 609-325-4630, ext.
133jpatricolo@mjhassoc.com