Marcus Welby, M.D., May Be Healthcare Reform Solution

Marcus Welby may be making a comeback – not to your television screen – but to your doctor’s office.  Partisans on both sides of the healthcare reform issue in Congress agree that general practitioners should play a starring role in unifying America’s disorganized delivery system.1

“Patient-centered medical home” – meaning a primary-care physician’s office that people visit for most of their medical needs – is the name being give to this vision.  This GP would monitor everything from flu shots to chronic disease management to weight loss and organize care with other practitioners.  According to a 2004 study, if every patient had a healthcare home, the resulting efficiencies could cut costs by 5.6 percent, or $67 billion per year.

This surprisingly simple solution streamlines a wasteful system that consumes 18 percent of the American GDP and a responsibility that falls primarily on private industry, which covers 60 percent of people with healthcare insurance.  IBM, which last year spent $1.3 billion on its employees’ healthcare – the equivalent of one month of the company’s income – has already bought into the concept.

Critics caution that the medical home is overly reminiscent of the “gatekeeper” model of 1990s managed care programs.  Supporters counter that this concept is intended to benefit patients versus insurers.  It’s more akin to practicing medicine 1950s-style, but with digital technology such as electronic medical records to assure a 21st century twist.

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