The Future of Primary Care.
Let’s consider a few facts:
- Only about 5% of graduating medical residents chose primary care as a profession for the past decade or so
- Primary care doctors earn $3.5 million less over their careers than specialists
- About 70% of primary care visits get referred to specialists
- About 60% of traditional primary care visits can be done over the phone or over the internet
- The average primary care visit is less than 8 minutes
- Patients forget 85% of the information told to them in an 8 minute visit
- Primary care office visits are possibly the worst tool imaginable to fix lifestyle and behavior problems
Nobody is going into primary care because the pay sucks and the traditional old-school notion of office-based primary care is the wrong tool for the problems that plague our culture.
The future of primary care is a completely different process. Primary care is about communication (90% via messaging, 10% via phone), problem-solving, and triaging to match the individual up with the right professional at the right time. Primary care must have real time access to available local resources. For example, when we get a call from a patient with a cut finger, we need to go to our group of professionals who can stitch that up and see their real time availability. It’s communication and coordination and matching up local demand and local supply. Primary care needs a “God-view” dashboard of ER wait times, ER availability, specialty centers, specialists, urgent care centers, etc. It also needs technology that functions more like a CRM like Highrise mixed with a customer service system more like Zendesk, but of course, designed for medical care.
Problems need to be triaged. We’re finding that about 50% of the problems coming in to Sherpaa can be handled without a doctor. Those problems that need a doctor are then sent to our dedicated virtual Primary Care Physician— a doctor available 24/7 via email or phone to solve the clinical problems that can be handled without a physical visit. And, for the rest of the issues that absolutely need a physical visit, we triage to exactly the right available expert who is best suited to solving the problem at hand. For Sherpaa, it looks a lot like this:
The primary care doctors have different roles— they emphasize communication and virtual problem solving rather than maximizing revenue from 8 minute office visits. Think of it like 311 for healthcare, but manned by local doctors with local connections to available resources. This is the future of primary care. It’s a whole different process. It’s a whole different experience. In fact, for patients, it’s a markedly better experience. Just give 311 a call. You can talk to a human in seconds. Imagine a system where you can talk to a local, super well-connected doctor in no time, exactly when you need it. Sounds wonderful doesn’t it?
Photo from Eugene Smith’s Country Doctor series