Welcome to the era of DIY health care in the U.S. Several factors are driving self-care in America:

• The recession, with the rise of a “creative commons” where consumers are doing more for themselves – including relying on home remedies and over-the-counter health products



• Under- and un-insurance, with more people avoiding going to health providers to avoid rising out-of-pocket costs in the forms of co-pays and coinsurance



• The proliferation of novel sites to receive health care, counsel and products beyond bricks-and-mortar doctors’ offices and hospital ambulatory care clinics.

At the same time, there’s a primary care shortage in the nation with some visible signs:

• A growing number of visits to the emergency room for treating commonplace ailments



• Waiting lists for signing up with and queuing lines to see primary care doctors



• Fewer med students entering primary care disciplines



• Maldistribution of primary care practitioners (PCPs) in underserved areas, rural, exurban and urban.

The implementation of the Affordable Care Act will (try to) enroll at least 30 million newly-insured health citizens into the U.S. health system. That’s the objective: whether being insured will actually provide people access to needed primary care is a big question given the current supply of internists, general medicine specialists, family physicians, pediatricians, and OB/GYNs.

Innovative providers are pioneering new models in team-based approaches beyond “the doctor” to include nurse practitioners, physician assistants, and certified nurse midwives. These teams are leveraging technology platforms such as EHRs, remote monitoring, Skyping with patients and secure emailing between patients and providers. And, more primary care is occurring at the workplace, in retail and urgent care clinics, in schools, and at the ultimate medical home — the patient’s own home.

Welcome to the era of Primary Care, Everywhere: the title of my new paper from California HealthCare Foundation. I interviewed many health system innovators on the ‘traditional’ side of the health system: hospitals, physician group practices, Federally Qualified Health Centers, school-based clinics, and individual doctors, along with novel entrants, from a developer of high-tech retail health kiosks to Walmart, worksite clinic providers and new-new house call companies.

These are novel entrants in primary care: pharmacies, retail clinics, worksite health centers, house calls (beyond old school home care), self-diagnostic vendors, videoconferencing health channels, and high-tech kiosks. These sites are often functioning independently from the health “system” per se. The Holy Grail solution is to connect these providers in accountable care communities, with the patient at the center. There are barriers to doing so, but the building blocks are aligning to move toward this vision: EHRs in doctors’ offices, interoperable standards that enable patient data at the point of care to move through the cloud and populate the patient’s record, savvier health providers keen to meet patients where they ‘live,’ and a growing appetite among consumers to receive care outside of the doctor’s office and hospital campus.

• ‹ Natural Beauty - Part 1
• What Are Budget-Friendly, Safer Bed & Bedding ... ›