List of Chapters
Introduction
Chapter 1: Primary Care in America: A Background History
Chapter 2: The Benefits of Primary Care
Chapter 3: The Decline of Primary Care
Chapter 4: Medical Training: The Education and Job Mismatch
Chapter 5: The Devaluing of Continuity of Care
Chapter 6: The Rise of the Hospitalists
Chapter 7: The Insurers take over Doctoring
Chapter 8: The Administrative Burden: Credentialing
Chapter 9: The Insurers as Doctors: Prior Authorizations
Chapter 10: The Insurers as Doctors: Referrals
Chapter 11: Primary Care: Drowning in Trivia
Chapter 12: The Lure of Quality
Chapter 13: The Electronic Medical Record: Unintended Consequences
Chapter 14: The Demonization of Fee-for-Service
Chapter 15: Severity Adjustment and the Gaming of Medicare
Chapter 16: The Advent of the Physician Substitutes
Chapter 17: Skimming the Fat: Urgent Care and Pharmacy Clinics
Chapter 18: Losing Vaccines
Chapter 19: The Shrinking of the Independents
Chapter 20: Between Scylla and Charybdis: Private versus Public insurance
Chapter 21: Restoring Rhyme and Reason: Some Solutions to an Impossible Task
Appendix: List of Proposed Reforms
Question: Is this book just based on your experiences as a PCP?
Answer: No. I have interviewed many other PCPs as well as researching what has been published about other doctors' experiences
Question: Is this problem due to the insurance companies?
Answer: No. As the book shows, multiple agents, including insurers, government, medical schools and doctors, have contributed to the problem.
Question: Can the system be fixed without huge expense?
Answer: Yes. I outline multiple reforms that are either cost neutral or reduce health care spending.
Question: Is it too late to prevent the demise of primary care doctors in the United States?
Amswer: I hope not. It is fixable if enough people realizes it is a problem that needs fixing.
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