| dc.description.abstract | Purpose: Primary care is an integrated, comprehensive approach to healthcare for most patient needs. Areas with a high supply of primary care physicians (PCPs) experience greater overall health, lower healthcare costs, and lower mortality rates. This study set out to determine how well the current reimbursement system captures the activities of PCPs. Methodology: Dr. Richard Young, MD and I observed ten Dallas-Fort Worth private practice and JPS-employed family physicians during forty-eight patient visits. The physicians and observers noted the number of problems managed per visit, the amount of time spent face-to-face and total time per patient. Data was divided by which Current Procedural Terminology (CPT) code was used for each visit, either 99213 or 99214. Results: For all 992123 visits, physicians self-reported managing 32.5% more problems, spending 24.5% more time face-to-face, and 119.5% more total time per patient than the reimbursable amount. 99214 visits averaged 143% more problems managed and 21.1% more total time per patient; interestingly, they spent 28.73% less time face-to-face with patients than the CPT-suggested amount. For both codes, doctors reported an average of 13% fewer number of problems managed than Dr. Young and I observed. Conclusions: Family medicine doctors manage more problems and spend more total time per patient than the current system reimburses. These findings reveal the shortcomings of the current reimbursement system to properly measure and remunerate the activities of family physicians. | |
