Explore new models
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YOU RIGHTLY identified the link between the uptick in non-urgent emergency room visits and the crisis in primary care ("The Marcus Welby shortage," Editorial, April 30), but the root of the problem is much broader than the shortage of physicians. According to recent research by the New England Healthcare Institute, we don't just need more Marcus Welby types, we need primary care doctors who think and work in new ways.
To meet the increased demand for primary care services fueled by older, sicker patients, new healthcare delivery models must be developed, with an emphasis on teamwork, where doctors, nurses, physician assistants, and other caregivers collaborate. The disparity in physician reimbursements, where doing procedures pays well but thinking deeply about a patient's problems does not, must also be addressed. Educating primary care doctors in new ways, and paying them for the quality, not the quantity, of care, would help keep our patients healthier and leave our emergency departments less crowded.
Dr. Joseph B. Martin, Boston
The writer is dean emeritus at Harvard Medical School, and a founder of the New England Healthcare Institute.
