The Best of Times, The Worst of Times: How Collaborative Care Helps Resolve the PCP Paradox
Authored by Hugh Barrigan, CTO of Mirah. Hugh is a 15-year multi-disciplinary software veteran with a history of building platforms in healthcare, travel, analytics and more. He co-founded Mirah to bring the best practices from other industries into the world of behavioral health.
Everyone knows that being a primary care physician right now is a nightmare. Between insurance, regulations, a growing number of mental health issues, and an increasingly ill population, primary care physicians are fighting for their lives (literally). According to the American College of Emergency Physicians, more than one primary care physician takes their life every day (source).
That’s why I was confused when a friend of mine – an actual, real-life primary care physician – told me that “there’s never been a better time to be a primary care doctor.”
Huh?
I wasn’t sure I believed him, so I took the question directly to a group of primary care physicians. Most agreed that it was a great time to be a primary care physician, but only if you were evolving with the field rather than trying to keep things exactly the same. They cited reasons like new clinical technology, business opportunities, and unprecedented access to information.
Living in this tension – between the “worst” and “best” of your profession – isn’t an easy feat. And with almost 40% of primary care physicians reporting at least one dimension of burnout, the question becomes: how can we use the things that are working well to reduce the pressure on physicians from the things that aren't working so well?
Now, before I get any further, let me make it clear: I am not a clinician. On paper, I am a software engineer and a CTO. But I think that this makes it my very job to consider issues like this. Technology shouldn’t exist just for technology sake. It should be built to solve problems. So, I consider it my responsibility to dive deep into better understanding industry challenges like this so I can think about how to better build solutions to address them.
With all that said: I think the answer to many of the problems primary care providers face is collaborative care. But, let’s rewind a bit and unpack the two sides of this coin before we get into that.
Why It’s Tougher Than Ever to Be a PCP
Fifty years ago, primary care meant a modest clinic in the heart of your hometown. Doctors made house calls, delivered babies, and cared for patients from cradle to grave. Relatively speaking, it was straightforward, easygoing, and most of all, often rewarding. That hasn’t been the reality of primary care for a while now – and recent health crises have introduced new stresses on the primary care system.
Here’s a closer look at some of the challenges PCPs are facing:
Increased Behavioral Health Issues: There’s been a massive rise in behavioral health issues. Doctors' primary care duties have expanded beyond dealing with common health and mental health concerns to dealing with severe mental health conditions and self-harm. Post-traumatic stress, anxiety, depression, and addiction struggles have intensified, demanding more behavioral health resources within primary care settings.
Staff Shortages: Nurses, specialists, and other important healthcare workers are in short supply. This shortage leaves primary care providers struggling to manage complex cases and patient referrals on their own, or spending too much time training new staff. The support network that PCPs once relied on is now stretched thin, adding to their already heavy load.
Physician Shortages: It's not just nurses who are scarce; the U.S. faces a projected shortage of between 37,800 and 124,000 physicians within the next decade, with primary care affected the most. This shortage leads to…
Pressure Around Access to Care: With fewer of them providing care, PCPs are now seeing more patients in a shorter time frame. Appointments are packed tightly, often with barely enough time to address each patient’s concerns in the way physicians have been trained. As a University of Chicago study puts it, “If they followed national recommendation guidelines for preventive care, chronic disease care and acute care, it would take a primary care physician 26.7 hours per day to see an average number of patients.”
In short, PCPs are being asked to handle more complex cases with fewer resources than ever before. It's no wonder burnout is at an all-time high – but why did the doctors I talked to say that things were better than ever?
Why It’s Better Than Ever to Be a PCP
While nearly 40% of primary care physicians report some level of burnout, many (like the ones I talked to) are more optimistic than ever about their roles.
Here’s why:
Generative AI Technology: Tools like ChatGPT are here to help with note writing, documentation, and patient engagement. This means more time for meaningful patient interactions and less time buried in admin tasks.
Collaborative Studies: Researchers around the globe are teaming up to source patients and collect data. This collaboration leads to stronger, more reliable results - which means that doctors are able to offer treatments that actually work.
Access to Instant Information: Doctors now have instant access to the latest medical information, allowing them to make well-informed decisions quicker and more confidently.
Integrated Models of Care: The future of healthcare is holistic. By integrating behavioral health resources into primary care settings, doctors can address both physical and mental health needs. This approach not only improves patient outcomes but also reduces stress on the doctors themselves. Apparently, the “many hands” approach works in healthcare, too!
There’s a lot that PCPs have going for them in the current healthcare system. And (spoiler alert!) it’s that fourth point that we’re all about at Mirah. In fact, we think that the Collaborative Care Model (CoCM) is even able to relieve some of the burdens that contribute to burnout.
How Collaborative Care Helps Resolve the Tension
There’s a good reason Mirah is all in on collaborative care. By integrating behavioral health care support into primary care settings, CoCM can mitigate many of the key factors contributing to physician burnout. Here’s how:
Team-Based Support: With collaborative care, the PCP’s heavy workload is shared. CoCM brings together a primary care provider, a behavioral health care manager, and a psychiatric consultant. This means PCPs aren't flying solo when handling complex behavioral health cases, which are becoming more and more common.
Improved Patient Outcomes: Better access to mental health care and systematic follow-ups lead to happier, healthier patients. When patients thrive, so do their providers. No one wants to work hard without results – seeing patients do well helps doctors love their jobs (and stay in them longer.)
Efficient Use of Resources: CoCM makes the most of healthcare resources by addressing mental health issues early. This proactive approach cuts down on the need for emergency care and hospitalizations, which can be the most stressful and time-consuming part of a PCP's job.
Enhanced Communication and Coordination: Regular team meetings and collaborative decision-making mean all healthcare providers are on the same page. This coordination results in more effective care and fewer errors, saving headaches and making life a lot easier for everyone involved.
Ongoing Training and Support: PCPs get continuous support and the latest best-practice information from their CoCM behavioral health specialists. This boosts their skills in managing mental health conditions, making them more effective and less overwhelmed.
Streamlined Care Processes: CoCM's systematic approach makes care more efficient and personalized. PCPs end up spending less time on each case, allowing them to manage their workload more effectively. With clear, structured processes in place, the cognitive load associated with decision-making is significantly reduced.
Better Patient Compliance: CoCM focuses on personalized care plans that address physical and mental health. When patients have plans custom-made for them, patient adherence to treatment plans and overall outcomes improve. Getting patients onboard and actively working for their health makes the doctor’s role more of a coach than a taskmaster, which is so much more rewarding.
If you’re a primary care physician, it might be easy to get caught up in the (considerable) challenges you’re up against, even if you believe that there are incredible advancements and opportunities as well.
Collaborative care offers a way to bridge this gap between the profession's pressures and the promise of modern medicine. By embracing team-based support, improving patient outcomes, using resources efficiently, enhancing communication, providing ongoing training, streamlining care processes, and boosting patient compliance, CoCM can help primary care physicians land safely in the “it’s the best time to be a PCP” camp.
Every primary care physician deserves to be optimistic about their profession. The Collaborative Care Model isn't just a solution to the current mental health crisis—it's a new way forward for primary care, too. By tackling burnout at its roots and leveraging the strengths of integrated care, CoCM is helping PCPs not only survive but thrive.
