The article “Women primary-care docs spend more time with patients, generate less revenue” is an unfortunate rear-facing view of primary care. As an administrator of primary-care clinics in Los Angeles, this gives me hope that women doctors in primary care are, perhaps unknowingly, preparing themselves to be more successful than their male counterparts.
The shift in primary care that focuses on team-based and value-based care of populations lends itself to increasing the value of primary-care visits, incorporating social determinants of health, health education, behavior modification and other forms of life-stabilization strategies. In California, there is a strong penetration of capitated HMO plans in the marketplace that reward primary-care practices for patient wellness, lower utilization of high-cost services, and better management of health maintenance. Many primary-care practices are thriving in this model.
The primary-care transformation is happening in other places like the University of Utah’s Care by Design model and the University of Colorado’s APEX model as discussed in an article titled “A team-based care model that improves job satisfaction” in the March-April 2018 issue of the American Academy of Family Physicians’ FPM journal. In these and other similar models, rather than the patients only seeking care when they are sick or injured, practices are becoming a place where patients can communicate more regularly with their primary-care team, and the most appropriate person on the primary-care team (often not the physician) is made responsible for responding to the patient’s concern or question.
The objective is for a primary-care practice to have a healthier patient population overall so the primary-care physician will be able to dedicate more time to those patients who really need the time with the physician, for which this article indicates women are better-suited.
In my opinion, the most unfortunate reality of the U.S. healthcare system is the fee-for-service model that values revenue generation (volume) over health outcomes (value). As the shift to value and prioritization of well care over sick care advances, perhaps women physicians are leading the way.
Chad Vargas
Chief operating officer
QueensCare Health Centers
Los Angeles
