Valuing the primary care patient base.

This analysis, albeit limited, can help clinics and integrated health systems with their medical staff planning, and it demonstrates the importance of the primary care patient base as a foundation for health services planning and economic and market strategies. It is important to note, however, that when primary, specialty, subspecialty, surgical, and hospital care are well planned and marketed, it is virtually impossible to identify the relative contribution of each to the overall success of the system. Consequently, primary care physicians should not attribute the value discussed here solely to their efforts. Hospital executives should be mindful of two related issues: First, some administrators remain focused on inpatient services when outpatient services may offer greater economic potential over time. Ambulatory interventional diagnostics and therapeutic procedures (e.g., outpatient surgery) are often undervalued or overlooked in medical staff development plans. The net profits available from additional ambulatory surgical cases can be significant. Second, success in developing a medical staff plan requires more than calculating physician supply and demand ratios. A balance must be struck between meeting the hospital's needs for additional physicians and meeting the needs of the existing medical staff. A number of hospital executives have found that devoting all physician-related resources to recruiting new staff can create resentment among physicians who have remained loyal to their hospitals without financial and other practice incentives and inducements. We encourage multispecialty group practices to become students of primary care development as well and urge them to guard against focusing on the high overhead costs of primary care without recognizing the value of an organized primary care strategy.(ABSTRACT TRUNCATED AT 250 WORDS)