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The problem with primary care?

It doesn’t generate profits for the medical-industrial complex.

From a societal perspective primary care is wildly undervalued – and wildly under-appreciated – because primary care doesn’t make money for anyone, especially primary care providers.

Which makes no sense on every front but the profit one. If everyone had good primary care,

  • they’d be healthier,
  • their health risks would be identified early and a plan developed to address them,
  • they’d have a provider who treats them as a whole person, who understands that we are a bunch of tightly-interrelated organ systems that have to be considered as a whole, not as individual organs,
  • they’d understand non-physical issues can be just as impactful as physical ones,
  • there’d be a lot less need for specialists, and
  • healthcare costs would likely be a lot lower.

Healthier people don’t need as many medications, devices, treatments, injections, therapies, surgeries, rehab, inpatient beds or surgical centers as unhealthy people.

And that’s where the money is.

Kaiser Permanente has generally excellent primary care – yet it can’t/hasn’t been able to translate that excellence into a sustainable competitive advantage.

I believe that’s because KP – and pretty much everyone else – is thinking about the “value” of healthcare the wrong way.

Tomorrow – how we define value today – and why that is wrong.

2 thoughts on “The problem with primary care?”

  1. I’ll be interested to see the follow-up. My take is that part of the problem is that large organizations keep buying up primary care practices, or already own them, and trying to turn them into profit centers by increasing “efficiency.” The net impact of that is that primary care (in that context) doesn’t lead to better outcomes or having a provider who treats the patient holistically, but rather as a widget. I agree with your premise that good primary care is wildly undervalued, but I don’t think it’s being delivered in a way that maximizes that value.

    1. Morning Les – thanks for the note and good to see you and Comp Laude.

      Completely agree re primary care isn’t being used effectively – methinks that is an effect, not a cause. That is, because it is under-appreciated and under-valued, we don’t focus on using it correctly.

      be well Joe

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Joe Paduda is the principal of Health Strategy Associates



A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.



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