The Most Boring Trip

The Primary Care Bottleneck
We are working with a large multispecialty group that wants to expand its primary care footprint, and the CMO identified their problem as primarily one of recruitment: “If we could just hire more primary care doctors…” everything else would work out. This type of thinking inevitably leads to discussions of medical education pipelines, imbalanced preferences for certain specialties and geographies, and plenty of other matters physician groups cannot control. I pushed back with a slightly provocative framing that throws recruitment out of the window. “Let’s say you were under a physician hiring freeze, how could you still expand access?”
 
In many cases, the capacity physician leaders want for their group already exists internally but has not been fully activated. Organizations have more tools, team members, and technology than ever before. We have been talking about physicians doing only what they can do for twenty years, in part because we have not sufficiently achieved this standard. In that time, APPs have flourished and technological advancements like AI have hit the scene, and yet we are still largely operating under the same care model. Patients have made it clear that their vision of improved access is faster responses, more convenience, and fewer unnecessary visits. Not everything requires a visit, and not every answer requires a physician, yet most primary care models still behave as if both are true. That gap, between how care is delivered and what is truly needed or desired, is the bottleneck we are really trying to solve.