The Primary Problem

Long the bedrock of medicine, the practice of primary care has been in need of a reinvention. Several models show promise. None of them will be cheap.

AFTER HER RESIDENCY, JULIE Gunther took a standard position for a new family physician, signing on with a large medical system in southern Idaho where she stayed for five years. “My vision was to serve my community as a sort of Marcus Welby,” Gunther says, a nod to the compassionate and fictional family doctor who appeared on television in the late 1960s. But the reality was nothing like that. Administrative hassles were always front and center, and the few minutes she had with her patients were scarcely enough for her to get to know them. “I was always apologizing for being late,” she says. “I felt like my patients were being pushed through in an assembly line.”

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