As difficult as the healthcare environment may seem for primary care physicians now, the industry’s move away from the fee-for-service payment model offers cause for optimism in the long run, writes Bob Doherty, senior vice president of government affairs and public policy at the American College of Physicians, in MedPage Today.

Despite the high rate of physician burnout and near-term worries over the effect of new legislation on small and independent primary care practices, Doherty suggests a longer perspective on the industry’s changes could signal a substantial improvement for primary care doctors in the future. He bases his case on a recent article by Robert Kocher, M.D., and Anuraag Chigurupati, in the New England Journal of Medicine, which argues that primary care physicians are strategically positioned to take advantage of changes in reimbursement patterns as the industry moves from the traditional fee-for-service model to one that requires practitioners to take on more risk.

“Their incomes are likely to grow substantially over the next decade, at the expense of hospitals and specialists,” says Kocher.

This take contrasts sharply with the bulk of physicians’ current broad-based dissatisfaction with the current state of the government’s implementation of the Affordable Care Act. To date, the most promising sources of savings signal that “reductions in volume and treatment intensity will most affect hospitals, skilled nursing facilities and specialists,” writes Kocher, which could turn into increased primary care revenues down the road since their annual average incomes tend to be less than those of specialists, but their influence on patients’ overall cost of care has proven much greater.

Doherty points to a number of proposals from the Centers for Medicare & Medicaid Services aimed at improving patients’ relationships with primary care physicians in order to lower cost and improve the value of care as evidence the industry is “moving in the right direction.”

- read the NEJM article

- here's the MedPage Today story