A study out this week [PDF] in the NEJM highlights the uncompensated “care”^[1] family physicians — correctly referred to in this NYT piece as medicine’s “embattled frontline” — must carry each and every day they continue to earn, at most, 50% of what many specialists pull in as income.

The study set out to show that the daily non-patient logistical workflow is a both a critical and burdensome task needed to be mastered in order to provide appropriate healthcare to patients — and as such, should be compensated. The study also highlighted the need for streamlined health information technology to incorporate these administrative tasks into a model that allows for the determination of compensation for primary care physicians.

A snapshot:

Family doctors are paid mainly for each visit by patients to their offices, typically about $70 a visit. In the practice in Philadelphia covered by the study, each full-time doctor had an average of 18 patient visits a day.

But each doctor also made 24 telephone calls a day to patients, specialists and others. And every day, each doctor wrote 12 drug prescriptions, read 20 laboratory reports, examined 14 consultation reports from specialists, reviewed 11 x-rays and other imaging reports, and wrote and sent 17 e-mail messages interpreting test results, consulting with other doctors or advising patients.

Credit the NYT for bringing this to the fore, but, if recent history is any indication; the continued erosion of interest in primary care for new medical school grads, the slow pace of legislative action on the issue of Medicare reimbursements in the age of continued cuts, and the seeming disarray and delay of the Obama administration in creating some sort of unified and prioritized timeline for implementation of IT enhancements — will continue to make the dystopian daily life of the busy primary care physician reliable and somber fodder for media outlets.

1. This is in reference to the myriad background logistical workflow issues family physicians must deal with on a daily basis on top of the direct patient interaction once thought of as the discrete point of care. [↩]

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