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Why Physicians Champion a Project Access System

All physicians already see charity patients. However, since there is no system for providing support services for these patients, the doctor often feels frustrated and views the care provided as being inefficient and ineffective.  Lab work, x-rays, and medications are not available, and patients may not come in for regular care since they cannot be compliant with the treatment plans. If the patient needs a referral to another physician, the original doctor must take time to personally call and negotiate the referral (somewhat embarrassing for both doctors) and taking more time away from seeing patients. In addition, no one but the physician, their office staff and the patients know how much of this the physicians are providing--it is unrecognized and not rewarded. So, why not see charity patients in an efficient and rewarding system, where doctors can see more of the patients, they can get the ancillary services they need and the care doctors provide is measured and reported to the community.

A small effort from many physicians results in huge impact in increasing access to health care.  There are significant ripple effects so that primary care sites can double their capacity when patients have access to specialists in timely fashion, can get labs x-rays and meds that are needed.

If all docs participate a little bit then no one doctor is overwhelmed.  Equity.

Doctors' standing in the local community improves as the general population recognizes that doctors are leaders in local solutions to improve health care access crisis.  This is not an insignificant issue.  As health care costs rise, physicians who lead their communities in Project Access efforts are viewed more as caring professionals, rather than as businessmen who care more for money than services.

When doctors work with other groups in the community to design Project Access-like programs the "abundance" of resources and assets are identified and can be used not only for PA programs but to help solve other issues, such as improving mental health services or dental services.

Physicians who participate in PA-like programs can set the standard for community service for other professionals, such as dentists and dentists who might then be encourages to provide pro bono work.

It is the right thing to do.  We all went into medicine to take care of patients.  Project Access allows is to do that and blend it in with our usual work in the office and hospital.

Suzanne Landis MD, MPH is an associate professor in the deptartments of family medicine and internal medicine at the University of North Carolina-Chapel Hill. She has an active medical practice and teaches family practice residents at the Mountain Area Health Education Center (MAHEC) in Asheville, NC located in western North Carolina. She was instrumental in starting quality improvement efforts at her practice and teaches quality improvement to residents and staff. Her practice has developed interventions in the areas of diabetes, asthma, and preventive screening which have significantly improved the care to their patients.