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The shortage of primary care providers has made it hard for families to find a provider. Photo: iStock
Editor’s note: This article was sponsored by the Western Washington Medical Group.
If it feels harder than ever to see a doctor, you’re not imagining things. A growing shortage of primary care providers has patients waiting weeks — or even months — for appointments. Some practices have stopped accepting new patients altogether. The result: Many people simply give up on routine care, turning to urgent care or the emergency room once problems get too big to ignore. Even those who manage to get an appointment often find their doctors constrained by corporate medicine: limited time, rigid policies and metrics that ignore the importance of relationships.
“The primary problem is that as our population ages there is the need for more clinicians. This is particularly acute in primary care since in general, there are incentives encouraging physicians to specialize,” says Dr. David Russian, a sleep and pulmonary physician and CEO of Western Washington Medical Group. Specialists can earn up to three times more than primary care physicians and face fewer administrative burdens. Others abandon the pressures of clinical practice in favor of well-paid work in pharmaceutical companies or other nonclinical settings.
The shortage of primary care providers has made it hard for families to find a provider who is accepting new patients, and when they do, they may wait months for an initial appointment. Meanwhile, administrative roadblocks created by insurance companies further decrease access to care: One-quarter of families have skipped child checkups and up to 90 percent of Americans have delayed or skipped well visits, only seeking health care for injuries or severe illness.
The corporate crunch
Most patients don’t think about the business structure of their health care provider. But many barriers to care are linked to the increasing corporatization of health care. Today, nearly 75 percent of physicians are employees of a hospital or corporate entity like a private equity firm. The traditional family doctor operating in solo practice is nearly extinct. But a handful of independent medical groups are working to preserve clinician autonomy and local control.
“An independent medical group is a group which is not linked with a hospital or some other larger corporation such as an insurance company. Similar to the older model, WWMG is not dependent on or controlled by a larger corporation,” says Russian. Instead, WWMG is owned by practicing medical professionals who live and work in the community. Because they answer to their patients instead of shareholders, independent medical groups like WWMG can help ease the primary care crunch.
While there are some smaller physician-owned medical groups in the South Sound, WWMG is the most comprehensive independent medical group in the region, with more than 100 providers in nearly two dozen specialty areas, primarily serving families in Snohomish County, and also in Skagit, Island and Whatcom counties.
“Western Washington Medical Group is one of the only integrated, multispecialty medical groups remaining in Puget Sound. No other independent group in the Puget Sound can provide care over the entire spectrum,” says Russian. While they include many of the same medical and surgical specialists that a hospital would, WWMG remains committed to expanding their capacity to provide primary care.
Routine preventive care saves lives, improves health outcomes and lowers overall health system costs.
- Child checkups that track growth can identify developmental delays and catch congenital conditions to enable early interventions for best outcomes.
- Annual wellness visits provide adults with an opportunity to discuss health concerns, set goals, and build a relationship with a trusted provider.
- Screenings and immunizations for all ages prevent disease and can detect illness before symptoms emerge.
As well as growing their existing family medicine locations, WWMG is also adding a primary care site in Bothell this June, to help meet the access needs of our growing community.
Independent care
When working with a patient, independent health care providers can pursue the treatment plan that they think best without conforming to prescriptive corporate treatment policies. They may choose a less profitable but more effective treatment informed by their knowledge of the individual patient.
“Corporations must generate a profit margin to stockholders, while being part of a large hospital situation often worsens inefficiencies, causing problems with both patient access and frustration among clinicians. An independent medical group maintains flexibility to provide better service to our patients and a better work environment for our providers,” says Russian. For example, independent providers can reserve a number of same-day appointment slots rather than booking out every minute. At the Lake Serene Clinic in Lynnwood, half of the clinic schedule is dedicated to same-day patient appointments.
When physicians govern their own groups, Russian says, “Board discussions focus on how to best take care of our shared patients. We do not have to worry about pleasing a corporate owner or filling hospital beds. For us, it is all about keeping our patients’ clinical pathway smooth and providing the right care in the right environment.” Typically, that environment is a familiar neighborhood clinic instead of an expensive, impersonal hospital.
But integrated care among group members not only makes it easier for families to navigate their health care, it can even improve health outcomes.
“In our group we coordinate care among primary care, medical specialists and surgical specialists. When we work together in an integrated way, it has been shown that patients will be healthier, and everyone who is part of the system is more satisfied. It creates a more seamless experience for patients and decreases some of the common frustrations people experience accessing care,” says Russian.
With lower turnover, physician-owned groups offer stronger continuity of care. Patients see familiar providers who know them, not just what’s written in their chart. In a health care landscape increasingly driven by corporate policy, groups like Western Washington Medical Group offer community-focused, relationship-based care that is personal, accessible, locally owned and close to home.
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