Washington, D.C.: Primary Care Hiring Microcosm

The Washington, D.C. metropolitan region healthcare system infrastructure may arguably represent one of the more competitive, complex, and innovative healthcare regions in the United States. According to a Washington Post article, Hospitals Courting Primary-Care Doctors (June 19, 2011), District of Columbia area hospitals are (and will be) taking an active role in hiring primary care doctors to achieve success under the Patient Protection and Affordable Care Act (2010) provision rewarding patient care teams for better coordinating patient services.

This article raises awareness of several key primary care issues such as: the evolving role of the primary care physician, the evolution of primary care networks, and the current and proposed future of primary care in the United States. However the immediate connection between an improved primary care network resulting in economies of scale, improved patient quality, and overall improved healthcare system efficiency is made only subtly transparent.

Primary care physicians operate as the healthcare system’s gatekeeper to specialty healthcare services. As a practice, strong primary care networks may allow for improved utilization and facilitation (less duplication) of healthcare services and procedures. Primary care physicians working nearby specialists may also provide increased knowledge transfer of healthcare information between physician groups, potentially of leading to improved healthcare outcomes.

From an urban perspective, primary care physicians with better coordinated access to specialists may significantly improve patient flow from emergency rooms, again improving utilization and system efficiency. At its most basic level, the perceived quality of patient care may increase, as patients relying on public transportation networks receive the benefit of improved access via primary care proximity to specialty services.

As a microcosm of the United States, Washington, D.C. area hospitals hiring reflects the following (Table 1):

Table 1: Washington, D.C. Region Current and Proposed Primary Care Physician Hiring
Hospital (Healthcare System) Primary Care Physician (PCP) Hiring Data Timeframe
Inova Health 200 PCP hires planned 5 years – 8 years
Montgomery General Hospital (MedStar Health) PCP system increased by 180 (represents a more than 20% increase) Increase over the last 18 months
Georgetown University Hospital (MedStar Health)
Washington Hospital Center (MedStar Health)
Suburban Hospital (Johns Hopkins Medicine) PCP hiring planned unknown
Sibley Hospital (Johns Hopkins Medicine)

As the hospital trend to hire primary care physicians continues, healthcare professionals should expect for hospitals to closely monitor the successes and challenges faced as primary care physicians. Moving forward, healthcare professionals and patients may also hear increased rumblings of physician shortages within primary care. The role of primary care networks in rural areas and hospitals may also come under increased scrutiny if rural or regional hospitals attract regionally-based, independent primary care physicians away from practice areas.

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