The internal medicine perspective: wisconsin primary care workforce From Health/Public Policy Committee

In Addressing The Summit’s Five Key Questions We Describe: 1)Problems with healthcare delivery system 2) Proposed solution-role of primary care 3)Role of the primary care internist 4)Barriers to achieving this role 5)Proposed approaches to surmount barriers 6)Mechanism for achieving these goals

Role Of The Primary Care Internist 1)Care for most complex and sickest patients 2)Serve as quarterback of PCMH team 3)Consultant and educator for team members 4)Key role in data analysis for quality improvement and practice redesign 5)Key role in the “medical neighborhood” coordinating care with medical subspecialists, hospitalists and other providers

Barriers 1)Adequate Reimbursement for physician and other members of the PCMH team 2)Development of integrated EMR system with hospital and other providers 3)Lack of training in team-based primary care 4)Protection from malpractice litigation 5)Relief from documentation burdens

Surmounting The Barriers 1)THC to augment prim. care pipeline-Table #1 2)THC to provide educational Innovations which would enhance recruitment- Table #2 3)Increase number of primary care internal medicine residencies – Table #3 4)Global capitation to allow reimbursement fornon-face-to-face internist functions, as well as the other members of the PCMH team 5)Repeal the SGR