Dr Charlie Fazio: Shifting Primary Care to Team-Based Care

Success in primary care should be based on how efficient and effective the physician is caring for the patient, and how satisfied the patient is with his or her care, rather than how many patients a physician is seeing in a day, said Charlie Fazio, MD, senior vice president and medical director of HealthPartners.

Transcript (slightly modified)

What challenges does primary care face in fulfilling its roles of developing patient-physician relationships and managing care across multiple areas?

It’s a tough time to be in primary care. If we look at all the things that are affecting practice on a day-to-day basis, let’s think about the fact that patients have high deductibles and so they don’t go to the clinic as often as they used to—maybe not for the easy stuff, where they’re seeking other sources of care for the easier stuff; so, that stuff is not on the schedule anymore.

But, I’m still being asked at a lot of practices to see 20 or 25 or 30 patients in a day; but they’re a little more complex than they used to be because of what’s not coming in, and I’m using an electronic medical record that, as it tries to support my practice more means I’m clicking more, means I’m spending more time in the electronic record. So, my day just gets more and more complex and I’m still, for the most part, working in a system that rewards how many patients I see, rather than the health of the population.

I think that’s just become a real grind for a lot of people. I think, to the extent that we can help to change that, to the extent that we can help primary care shift to a point where with a team-based approach to care—and with being paid more to take care of people with chronic disease, and to take care of a population of people—so that success ends up being: how healthy are those people with whatever else they might be dealing with from a chronic disease basis? How satisfied are they with their care? Then, how efficient was I and my team in taking care of those people? So, when we maximize those that should be success, rather than how many people I see in a day.