Family physicians tied to lower readmissions

The authors looked at the same three conditions that the US Department of Health and Human Services uses to judge hospital readmissions: pneumonia, heart attack, and heart failure. They used the county-level analysis to project what would happen if the number of family physicians per capita increased nationally.

Today, there are about 33 family doctors per 100,000 people. Increasing that to 46 would reduce the $1.3 billion annual cost of readmissions related to the three conditions by $81 million, the report says. An increase to 100 physicians would cut $579 million.

The idea is that more primary care doctors would be available to guide patients through the health care system and provide timely follow-up care. Those cost savings are just in readmissions, said author Dr. Brian Jack, vice chairman for academic affairs in the Department of Family Medicine at Boston University School of Medicine and Boston Medical Center.

“Of course family physicians save money in a lot of other ways because they work in the community," Jack said.

Jack is principal investigator on Project RED, short for re-engineered discharge. His office has worked to put together personalized booklets that provide patients being discharged with information they need about medications and future appointments. Now they are designing a bedside kiosk on which "Louise," a virtual advocate, goes over that booklet in detail with the patient. The program is being tested at Boston Medical Center and elsewhere.

The biggest barrier to reaching the higher physician numbers is recruiting, Jack said. We reported this morning on a new study that says fewer medical students are choosing to pursue general internal medicine (scroll down the page) as their average debt is rising. Jack said more incentives are needed.

I would like to hear from doctors on this: What drew you to or deterred you from family medicine? As a family physician, what do you think families need to successfully adjust after a hospital stay?