November 2016: The Changing Face of Primary Care Medicine

In June 1952 my father opened North Scituate Pharmacy in the northwest part of Rhode Island. Next door was the primary care office of Robert F. Spencer, M.D., whose character resembled the beloved and kindly Marcus Welby, M.D. There was even a pass-through window between the drug store and doctor’s office so patients could get their prescriptions filled before leaving. It was a simpler way of doing things.

The independent pharmacy and the family doctor are rapidly becoming history. Large retail chains now rule the drug store market; large, hospital-employed medical groups now rule the primary care market. The large retail drug chains seem to be thriving. But when it comes to large primary care practices, both senior leadership and providers wonder where it’s all going. Burnout, demanding consumers, fewer medical school graduates, administrative burdens, complex productivity goals and new competitors are all adding up to make primary care’s long-term survival somewhat of a question mark.

Are things really that bad for traditional primary care medicine? Should we really believe those observers who say things are only going to get worse?...