UT Dallas expert says primary care industry poised for seismic shift post-coronavirus

The coronavirus has rattled primary care clinics across the nation as doctors are forced to brave an unprecedented public health crisis amid losses of staff and revenue.

A recent nationwide survey by the Primary Care Collaborative showed that more than half of responding clinicians reported feeling unprepared for the next wave of the pandemic. But one expert argues challenges faced by clinicians could be the impetus for much needed change in the industry.

“I think you’re going to see less episodic care and more comprehensive care. You’re going to see more attentiveness to what the demands are of the community. You’re going to see more awareness and consumerism,” said Britt Berrett, director of the Center for Healthcare Leadership and Management at The University of Texas at Dallas.

The primary care system was fragmented prior to the coronavirus, Berrett said. Advances in medicine that called for more sophisticated technology drove many doctors to collapse into established health care systems, while others chose to remain independent.

Financial devastation sustained during the pandemic will likely put the final nail in that coffin, Berrett said. According to the Texas Medical Association, 60% of physicians at a recent town hall said revenue at their practice was down by half or more.


“The days of the solo practitioner really have gone,” he said. “Everyone is integrating, and you’re seeing that all across the United States.”

The loss of mom-and-pop clinics may seem grim, but Berrett said he believes integration is essential to value-based care. Services become more efficient and less costly when patients can get everything they need in one place, he said.

The pandemic has also spotlighted problems with the way doctors are paid, Berrett said. Primary care has traditionally operated on a fee-per-service model, meaning physicians are reimbursed based on the number of patients they see.

But shelter-in-place orders that have kept patients out of doctors' offices have undermined the sustainability of that system. According to a recent survey by the Primary Care Collaborative, about 20% of respondents said their practice was forced to temporarily close due to a lack of funds.

This will likely lead to more doctors being paid on a guaranteed schedule, Berrett said. The concept of predictable payments is popular among physicians, with 30% in support of the practice, the same survey from the collaborative showed.

“In the new environment, a primary care physician will get a monthly amount to treat and take care of you, and if he or she is efficient in that care so that you don’t have to go to the hospital, he or she participates in gain sharing,” he said.

Guaranteed payments will also allow doctors to focus on quality over quantity. Rather than trying to shuffle through as many patients as possible, doctors will have the bandwidth to prioritize comprehensive, preventative care.

“Compensation has to be focused on treatment over a long term, not episodic ... so you’re going to see us move from medical care to health care,” he said.

This will be essential as health care providers turn their focus away from treating the acute condition of COVID-19 and back to the management of chronic conditions, such as diabetes, Berrett said.

According to the collaborative, preventative care is largely not happening. Survey results from May 15-18 show only 5% of doctors reporting the continuation of cancer screenings and only 15% reporting the administering of routine childhood vaccinations.

“Individuals have not been able to get to the primary care physicians or their doctors because of the pandemic,” he said. “They have postponed treatment and care, even diagnosis, and there is a very large concern about it.”

A restructuring of the reimbursement model will also motivate more doctors to go into primary care rather than pursue more specialized areas of medicine, Berrett said.

“The compensation model into the future will benefit primary care,” he said. “That is absolutely, unequivocally the trajectory that we are seeing.”

Another service positioned to explode as a result of the pandemic is telehealth. In a poll conducted during the Texas Medical Association’s town hall, nearly 75% of doctors said they began using telemedicine for the first time only after March 1.

The forced shift to telehealth has been difficult on providers, but ultimately it should serve to heighten a doctor’s ability to provide convenience care for patients, Berrett said.

“All of us agree that [telemedicine] ... will provide greater value for primary care,” he said.

Public health is now more important than ever, and patients will begin to demand improved access to care, Berrett said. Post-coronavirus, success for a doctor will be rooted in his or her ability to cater to the patient.

“You can get into an Applebee's faster than you can get into a primary care physician’s [office],” he said. “Now, those days are gone.”
By Olivia Lueckemeyer
Olivia Lueckemeyer graduated in 2013 from Loyola University New Orleans with a degree in journalism. She joined Community Impact Newspaper in October 2016 as reporter for the Southwest Austin edition before her promotion to editor in March 2017. In July 2018 she returned home to the Dallas area and became editor of the Richardson edition.


MOST RECENT

Crumbl Cookies offers over 120 rotating cookie flavors. (Courtesy Crumbl Cookies)
Crumbl Cookies to open in Plano; McKinney trash pickup rates to rise and more DFW-area news

Read the latest business and community news form the Dallas-Fort Worth area.

Diesel Barbershop
Vintage-themed Diesel Barbershop now open at CityLine in Richardson

To celebrate its grand opening, Diesel Barbershop will host a ribbon cutting at 4 p.m. on May 5, and it will welcome guests from 4-9 p.m. to check out the new shop.

Student walking into school.
Plano ISD to receive $43M in federal COVID-19 relief funding

“These additional funds will be a tremendous help in facilitating a comprehensive, long-term approach to support students and staff affected by the pandemic,” Plano ISD Chief Operating Officer Theresa Williams said.

Frankford Middle School.
Plano ISD to partner with Dallas for park at Frankford Middle School

Plano ISD will not contribute any funds toward the park, but will be able to reserve it for the district's exclusive use.

Richardson senior center.
Richardson sets membership structure for newly renovated senior center

When the freshly renovated Richardson Senior Center reopens in June, nonresidents will be required to pay double the amount that residents purchasing new memberships will be charged.

Early voting location.
Tyra, Powell, Humphrey, Chambers win Plano ISD board of trustees races

Election day results from May 1 show Lauren Tyra won the Plano ISD board of trustees Place 1 race and incumbents Angela Powell, Nancy Humphrey and Jeri Chambers won the races for Places 2, 3 and 6, respectively.

Students on computers.
Richardson ISD voters approve $750M bond package

Election day results from May 1 show Richardson ISD's $750 million bond package was approved by more than 63% of voters.

Early voting location.
Poteet, Clair to have runoff for Richardson ISD Place 7, Timme wins District 1 seat

Election day results from May 1 show Christopher J. Poteet and Amanda Clair headed for a runoff for the Richardson ISD at-large Place 7 seat and Megan Timme winning the single-member District 1 race.

Early voting location.
Shamsul, Frederick head to runoff for Richardson City Council Place 6, Corcoran wins Place 4 seat

Election day results from May 1 show Arefin Shamsul and Marilyn Frederick headed for a runoff for the Richardson City Council Place 6 seat while Joe Corcoran defeated incumbent Kyle Kepner for the Place 4 position.

Three incumbents faced challengers vying for seats on the Collin College board of trustees in the May 1 election. (Courtesy Collin College)
Incumbents defeat challengers in elections for Collin College seats

Unofficial election results on May 1 show the incumbent candidates defeated their challengers in the races for Collin College board of trustees seats.

Early voting location.
Plano ISD board of trustees election features 4 contested races

Plano ISD voters will decide on Places 1, 2, 3 and 6 on the district’s board of trustees May 1. Polls are open from 7 a.m. to 7 p.m.

Vote sign.
Richardson ISD board of trustees election features 2 contested races

Richardson ISD voters will decide on new members for the single-member District 1 and at-large Place 7 positions on the district’s board of trustees May 1.