Abstract
It is widely recognized that the dramatic increase in health care costs in the United States has not led to a corresponding improvement in the health care experience of patients or the clinical outcomes of medical care. In no area of medicine is this more true than in the area of spine related disorders (SRDs). Costs of medical care for SRDs have skyrocketed in recent years. Despite this, there is no evidence of improvement in the quality of this care. In fact, disability related to SRDs is on the rise. We argue that one of the key solutions to this is for the health care system to have a group of practitioners who are trained to function as primary care practitioners for the spine. We explain the reasons we think a primary spine care practitioner would be beneficial to patients, the health care system and society, some of the obstacles that will need to be overcome in establishing a primary spine care specialty and the ways in which these obstacles can be overcome.
Highlights
One of the most talked about issues in the United States (US) is health care reform
While various models for providing care to patients have been considered, such as accountable care organizations [6], it is recognized that any meaningful approach to health care reform will require three goals to be achieved: 1. improved patient health; 2. improved patient experience; 3. decreased per capita costs [7]
We suggest that the introduction of the primary spine care practitioner can serve as a disruption in the delivery of spine care services that could potentially lead to dramatic improvements in the delivery, accessibility, cost and outcomes of this care
Summary
One of the most talked about issues in the United States (US) is health care reform. In other countries as well, discussion commonly revolves around the issue of how health care services can be improved while containing costs. Primary Care for the Spine “Primary care” is defined by the American Academy of Family Physicians (AAFP) as “that care provided by physicians trained for and skilled in comprehensive first contact and continuing care for persons with any undiagnosed sign, symptom, or health concern (the “undifferentiated” patient) not limited by problem origin (biological, behavioral, or social), organ system, or diagnosis” [30]. To paraphrase the AAFP definition for our purpose, “primary spine care” can be defined as “that care provided by practitioners trained for and skilled in comprehensive first contact and continuing care for persons with any undiagnosed sign, symptom, or health concern (the “undifferentiated” patient) not limited by problem origin (biological, behavioral, or social), involving the spine“. Essential in this regard is an understanding of when diagnostic testing is not necessary [38] as efficiency and cost-effectiveness would be an essential aspect of primary spine care
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