Sebelius says laws will boost primary care

Provisions in recently approved healthcare laws, including this year's health reform act , will lead to a resurgence in primary care, HHS Secretary Kathleen Sebelius said at a meeting sponsored by Health Affairs in Washington.

“There's no question that the legislation put in place since January 2009 will usher in a new era for primary-care providers,” Sebelius said, adding that the health information technology investments and promotion of medical homes and accountable-care organizations under the new health reform law and last year's stimulus legislation should help to revitalize the primary-care profession, which has been suffering from shortages and a lack of interest among medical students.

These types of workforce issues “are a critical piece of the puzzle” in reforming the healthcare system, Sebelius said, acknowledging the primary-care shortage is something that won't be solved overnight.

The current system “is horribly broken,” stuck in a bygone era where physicians are paid only for in-person visits, said Susan Dentzer, Health Affairs' editor-in-chief, during the meeting.

Lawrence Casalino, chief of the Division of Outcomes and Effectiveness Research at Weill Cornell Medical College, New York, cautioned that few practices will adopt concepts such as the patient-centered medical home unless reforms are carried out to change how primary-care doctors get paid—and how they schedule their workday. “Primary-care physicians can't carry out medical home responsibilities if they are simply added to 25 patient visits a day,” he said at the meeting.

Instead, doctors should be scheduling fewer face-to-face visits and getting reimbursed for e-mail and phone communications for routine medical problems, Casalino said.