Obama Understands the Importance of Primary Care

Based on these remarks, it is clear to me that President Obama has a vision for changing our healthcare system to improve primary care:

President Obama Calls for Better Payment System for Primary Care Physicians -- AAFP News Now -- American Academy of Family Physicians

"It used to be that most of us had a family doctor," said Obama. "You would consult with that family doctor. They knew your history. They knew your family. They knew your children. They helped deliver babies."

Now we often have a mishmash of consultants dealing with each organ in a patients body, instead of having someone deal with the whole person:

"Now in these big medical systems, so often, what happens is that you're shuttled around from (sub)specialist to (sub)specialist," said Obama. "Oftentimes, people don't have a primary care physician that they're comfortable with, so they don't get regular checkups. They don't get regular consultations. Preventable diseases end up being missed, and you don't have the kind of coordination that's necessary between all these different specialists."

Then he agrees with my JAMA editorial from early this year:

"Right now you've got a situation where if a primary care physicians says to a patient, 'You know what, you need to lose some weight because you're at risk of diabetes, and I've got a good exercise program that makes sense, and here's a dietitian that you should talk to,' sometimes Medicare may not reimburse that consultation," Obama said.

But, he noted, Medicare will pay $30,000 for a foot amputation that results from the ensuing diabetes.

Let's fix this. One first step is to get Dr. Don Berwick confirmed as director of Medicare and Medicaid Services. We need an innovative thinker to help transform our system into a modern health system, that focuses on primary care, prevention, and everyone having a personal physician.