Reallocation of Care Would Increase PCPs' Work Weeks

Study investigates plausibility of reallocating specialty care follow-up to primary care physicians

WEDNESDAY, Nov. 24 (HealthDay News) -- Specialists spend a substantial amount of time providing routine chronic disease follow-up care, and reallocating half of this care to primary care physicians (PCPs) would add a few work weeks for each PCP, according to research published online Oct. 18 in Medical Care.

John M. Hollingsworth, M.D., of the University of Michigan in Ann Arbor, and colleagues used the 2007 National Ambulatory Medical Care Survey and 32,778 office-based encounters to determine the implications of reallocating half of the care provided by specialists for several chronic conditions to PCPs. Patients in the study suffered from chronic obstructive pulmonary disease/asthma, low back pain, diabetes mellitus, coronary artery disease/congestive heart failure, chronic kidney disease, or depression.

The study revealed that specialists spent 552,844 cumulative work weeks providing direct follow-up care for mostly established patients and 108,113 work weeks on indirect care. Redistributing half of the specialty care to PCPs would add 3.2 work weeks annually for each PCP. This is the equivalent of increasing the primary-care work force by 6,355 physicians, the authors note.

"The cumulative time spent by specialists in routine chronic disease follow-up is nontrivial. Reallocation of this care to PCP-directed medical homes may require multidimensional efforts to expand the primary-care work force," the authors write.

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