MC-Class Product 3

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PRIMARY CARE PHYSICIANS

Primary Care Physicians ("PCP") are a key link between managed care organizations and the medical delivery system. This class will examine more closely how capitated payment effects the Primary Care Physician, illustrate some potential opportunities Primary Care Physicians face under managed care, and examine some primary care physician?s perspectives of managed care. This class will also identify some specific questions that Primary Care Physicians should ask themselves as they form networks or consider joining them.

Class 3 Topics:    PRIMARY CARE PHYSICIANS

I. WHAT IS A PRIMARY CARE PHYSICIAN

II. HOW CAPITATED PAYMENT AFFECTS PRIMARY CARE PHYSICIANS

III. FROM A MANAGED CARE PERSPECTIVE, ISSUES TO CONSIDER FOR PRIMARY CARE PHYSICIANS

IV. PRIMARY CARE PHYSICIAN?S MIX OF SERVICES PROVIDED IN A MANAGED CARE ENVIRONMENT

    A.    Hospitalists

    B.    Physician Assistants, Nurse Practitioners and Others

    C.    Alternative Care

V. HOW NETWORKS EFFECT PRIMARY CARE PHYSICIANS

VI. OPPORTUNITIES FOR PHYSICIAN ORGANIZATIONS UNDER MANAGED CARE

Key Objectives

1. Analyze how managed care effects Primary Care Physicians.

2. Distinguish how capitated payments effect Primary Care Physicians.

3. Synthesize trends involving Primary Care Physicians.

Review

1. Examine scope of care issues for Primary Care Physicians under managed care, including gatekeeper issues and hospitalist issues.
See: Kevin Grumbach, M.D., "Primary Care in the United States - The Best of Times, the Worst of Times," The New England Journal of Medicine (December 23, 1999): 2008 - 2010. Miguel Buxeda, M.D., "The Scope of Practice in Primary Care," The New England Journal of Medicine (May 11, 2000): 1453. Mark Crane, "Malpractice: Who?s On the Hook," Medical Economics (March 6, 2000): 54. Sean Schafer, M.D., William Shore, M.D., Lloyda French, et al., "Rejecting Family Practice: Why Medical Students Switch to Other Specialties," Family Medicine (May, 2000): 320 - 325.

2. Analyze economic/ financial issues for Primary Care Physicians under managed care, distinguishing the effect modes of payment such as capitated payments from fee-for service and discounted-fee-for-service has on Primary Care Physicians.

See: Peter A. Setness, M.D., "Escaping the Professional Pressure-Cooker," Post-Graduate Medicine, Vol. 106, No. 6 (November, 1999): 11.

3. Analyze business issues for Primary Care Physicians under managed care, including: (a) office management issues such as making the most out of staff, telemedicine, Internet, and technology; (b) Physician Assistants or Physician Extenders; (c) Alternative Care such as chiropractic, acupuncture, massage therapy, etc., (d) Patient Satisfaction issues.
See: Ken Terry, "Re-Engineer Your Practice - Starting Today," Medical Economics (April 24, 2000): 42- 49. Ken Terry, "Now Patients Will Rate You Online," Medical Economics (April 24, 2000): 42 - 49. Jo Surpin, "The Future of Health Care," Health Care Strategic Management (March, 2000): 6 - 17. Deborah Grandinetti, "Make the Most of Your Staff," Medical Economics (April 24, 2000): 56 - 66.

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