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Parkinson, MD: “Primary care fails people surprisingly often.”

By Jay Parkinson, MD, MPH | Physician | CEO | Speaker | Created a new model of healthcare delivery: Virtual Primary Care


Patients view doctors as problem-solvers. And this perception works extremely well in doctors’ favor throughout your life. When you’re young, you get sick or hurt. You go to the doctor. They cast your broken arm or prescribe you your bubble gum-flavored amoxicillin and soon you’re all better. From day one, your doctor works miracles. Then you turn 18 or so and graduate from your pediatrician and it’s pretty much the same thing. The issues you face as a 20, 30, and 40-something look more like pediatric issues (sickness and injury) than geriatric issues (cancer and heart disease). Depending on your lifestyle, you don’t start dipping your toe into geriatric-like health issues until you’re in your 50’s and 60’s. That’s when the chronic issues start and doctors start treating you with things that have a NNT of 300, instead of 1 or 2.

You’re so used to doctors fixing you up right quick that these new kinds of drugs for your new chronic diseases don’t seem to be working as quickly as your previous miracle-working doctors. But you still keep the faith because you’ve got decades of miracles under your belt.

But is this true? When you spend time and money on a PCP doctor visit in your pediatric-like phase, what’s the “failure rate?” What percent of the time does your doctor visit not fix your problem? How often does your doctor:

  • Do nothing (or prescribe some sort of placebo-like medication because they’re afraid you will think they did nothing for you) because you just have to wait it out (example: common cold)
  • Give you a treatment strategy that doesn’t work (example: a year of allergy shots and your allergies still bother you)
  • Refer you to a specialist because they are pressed for time or lack the expertise
  • Tell you there’s a 3 week wait for an appointment forcing you to scramble for some other doctor/urgent care



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