Rethinking Patient Flow

Joe Flower wrote a very interesting article "Change The Model" in the July 9, 2008 on-line issue of H&HN Magazine, discussing the increasingly difficult climate for hospital survival. In it, he notes that while capital is necessary to a provider's growth and success, "the most important input a hospital needs is patients". And the critical factor in patient flow is the primary care physician.

However, he notes the decline in primary care doctors, to the point that in 2005, only 8% of medical school graduates were going into family practice. If the hospital model is dependent on patient flow coming from primary care physicians [or from specialists who themselves have been referred to by primary care physicians], then this shrinking of primary care doctors necessitates a rethinking of the hospital model and where and how the flow of patients can be generated. Flower's solution is that hospitals must increasingly take on the role of primary care providers and he suggests a number of ways to do this.

His solutions, however, seem to fall short of really addressing the issue of increasing the supply of primary care physicians. Companies like Sun Capital HealthCare, Inc. can provide the financial means and working capital hospitals need, but for the healthcare system to survive, the need to attract more primary care doctors into the system must be addressed. Financial incentives, medical school curriculums, geographical considerations, electronic records/remote capabilities, etc. all must be considered when looking at redefining the hospital model and reinvigorating a healthy healthcare system that is referral based. Let's bring back "housecalls" to the healthcare system.