Primary care is in crisis and the situation is critical

May 27, 2021

Imagine you are in an ICU - look to your left and right - among the COVID-19 patients on life support, there among them is primary care. It is taking its last breaths and the end is near, very near.

Things have been brewing for some time, and the pandemic has only magnified various issues involving primary care and made them worse.

 Why should you pay attention to what is happening with primary care?  If you care about your health and that of your family members and others, you need to take heed.

 Let us take a step back for a moment and think about what primary care is all about.  The Merriam-Webster dictionary defines primary as that “of first rank, importance, or value.”  I think we would agree primary care fits the bill for that.  Whether it means family medicine, internal medicine, pediatrics, obstetrics/gynecology, or some of the specialties, primary care is the entry point to the healthcare world for most.  However, as many of us have noted for some time, making an appointment to see a doctor isn’t easy. There are often long waits and lots of frustration as the primary care world continues to shrink. Yet these are the doctors that patients come to know well and vice versa. These are relationships that once established can last a lifetime.  

There is a crisis in access and care as more physicians retire/leave practice in Delaware due to low investment in primary care compared to the rest of the nation and above-average costs of practice within Delaware. The pandemic has fueled the fire.  Physicians are leaving practice early to retire, join hospital systems as employees, become concierge doctors, or move out of state.  As it is, many physicians are fatigued, burned out and depressed.  In other words they are suffering from “moral injury.”

The passage of Senate Bill 120 provides an innovative and effective framework that supports primary care as an important foundation for cost-effective delivery of quality healthcare.  It addresses the unsustainable increases in total healthcare spending in Delaware.  It will lead to a less steady rise in costs. It also ensures access is maintained and possibly even expanded with a focus on value-based care.  These changes will result in improved health outcomes and not higher premiums or costs.   

A recent report from the National Academies of Sciences, Engineering, and Medicine emphasizes that “primary care should be a common good, made available to all individuals in the U.S., promoted by responsible public policy, and supported with the resources to achieve health equity.”  

 The Medical Society of Delaware will continue to fight long and hard for primary care in Delaware, and it won’t stop until there is change and progress now and in the future.  

Please reach out to your legislators to fight for primary care.   Fight the fight to establish and maintain a robust primary healthcare environment in Delaware.  

We owe it to ourselves and those who will come behind us.  Help to have primary care lead the way.

Matthew Burday, D.O.
Medical Society of Delaware
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