Pri-Med Southwest Attendees Celebrate the Promise of Primary Care

John Goodson, MD, opens Pri-Med Southwest 2011 with a keynote address highlighting primary care innovation and advocacy and advice for future success.

The 2011 Pri-Med Southwest conference opened with a keynote address by John Goodson, MD, FACP, who is Deputy Director of the Harvard Medical School Course Development Committee and a primary care practitioner (PCP) at Massachusetts General Hospital. In his talk, titled “The Promise of Primary Care,” Goodson focused on the pressures faced by the profession from conflicting demands, reductions in the workforce, and the reimbursement environment. Goodson crafted his address as a call to arms. He encouraged PCPs to join a grassroots effort to rebuild primary care with a focus on three essential elements: the workforce pipeline, payment issues, and practice reform.

Celebrate the profession and embrace the idea of the patient-centered medical home

Interest in primary care specialties among medical school graduates and residents has dropped and a workforce crisis is looming. PCPs need to reverse this trend by expanding interest in the profession. Goodson advised PCPs to replace their negative rhetoric with a celebration of primary care and to teach and mentor students at every level.

Although Goodson prefers the term “advanced primary care practice,” he believes the patient-centered medical home movement will raise public and corporate awareness of what PCPs do and will reveal the complexity and value of the profession.

Take advantage of payment reform

In 2004, PCPs earned a fraction of the salary earned by specialists, contributing to both poor job satisfaction and disinterest in the profession among trainees. PCP remuneration can be increased by utilizing billing options introduced in the Affordable Care Act 2010 (ACA). PCPs should also pay attention to ongoing and prospective payment reform efforts.

Through the ACA, two new CPT service codes were established for new and subsequent annual wellness visits (AWV). These will allow PCPs to bill for services that were not previously covered. Over the course of a year, if a practice performed 500 first time AWV on Medicare patients, it would generate an additional $25,500.

Certain PCPs will also qualify for a 10% bonus based on their Medicare billings from 2011 through 2015.

Voice is essential

Goodson urged attendees to make time for advocacy. When valuing CPT service codes, CMS relies heavily on the recommendations of the AMA’s Relative value Update Committee. Representation of general medicine on this committee is poor. The ACA has mandated a review of the values assigned to these codes. PCPs need to get involved, make their voices heard, and demand that their professional societies express their expectation for compensation parity. Goodson called for attendees to join and to become active members of professional organizations.

Practice reform

Goodson discussed the value of what PCPs know about their patients and the importance of managing this valuable commodity. He stated that, “well-maintained personal records assert your belief in the power of this information” and went on to point out that these records can be exploited to position primary care during healthcare reform.

The Health Information Technology for Economic and Clinical Health (HITECH) Act provides ample resources with which to establish electronic health records (EHR). Financial incentives will be provided to “meaningful users” of EHR between the years 2011-2015. More information on the HITECH Act can be found at HITECH Answers.

Become an agent of change

Goodson discussed the need to invigorate primary care and warned against the profession developing a reputation for “curmudgeonliness.” He offered several suggestions for primary care physicians, including:

• Be a leader in your own practice.
• Make time for innovation and team brainstorming.
• Collaborate and cooperate with your colleagues, for example, invite a colleague to watch you practice; do it for someone else.

More detailed information on the issues discussed by Goodson can be found on his website, The Promise of Primary Care.