Ridiculous Study of the Week: Optimal Primary Care Panel

This one is kind of hilarious. First, the entire abstract:

What Is the Optimal Primary Care Panel Size?: A Systematic Review

Abstract

Background:

Primary care for a panel of patients is a central component of population health, but the optimal panel size is unclear.

Purpose:

To review evidence about the association of primary care panel size with health care outcomes and provider burnout.

Data Sources:

English-language searches of multiple databases from inception to October 2019 and Google searches performed in September 2019.

Study Selection:

English-language studies of any design, including simulation models, that assessed the association between primary care panel size and safety, efficacy, patient-centeredness, timeliness, efficiency, equity, or provider burnout.

Data Extraction:

Independent, dual-reviewer extraction; group consensus rating of certainty of evidence.

Data Synthesis:

Sixteen hypothesis-testing studies and 12 simulation modeling studies met inclusion criteria. All but 1 hypothesis-testing study were cross-sectional assessments of association. Three studies each provided low-certainty evidence that increasing panel size was associated with no or modestly adverse effects on patient-centered and effective care. Eight studies provided low-certainty evidence that increasing panel size was associated with variable effects on timely care. No studies assessed the effect of panel size on safety, efficiency, or equity. One study provided very-low-certainty evidence of an association between increased panel size and provider burnout. The 12 simulation studies evaluated 5 models; all used access as the only outcome of care. Five and 2 studies, respectively, provided moderate-certainty evidence that adjusting panel size for case mix and adding clinical conditions to the case mix resulted in better access.

Limitation:

No studies had concurrent comparison groups, and published and unpublished studies may have been missed.

Conclusion:

Evidence is insufficient to make evidence-based recommendations about the optimal primary care panel size for achieving beneficial health outcomes.

Primary Funding Source:

Veterans Affairs Quality Enhancement Research Initiative.

So, their answer for the optimal primary care panel size is………….they have no f$cking clue.

Unbelievable.

The problem starts right from the beginning. “Primary care for a panel of patients is a central component of population health”. Population health? Here the narrative is being changed to make primary care docs feel that their duty is to control the population. Whatever happened to treating the patient right in front of you?

Next was the supposed purpose of the study: “To review evidence about the association of primary care panel size with health care outcomes and provider burnout.” See how they put health care outcomes in there again? This goes back to population health. All to justify bogus quality metrics. They want us to be cattle herders. Hell, maybe we should just put antibiotics and cholesterol in all the water supply. That would hurt some but help possibly more. That’s population health management, isn’t it?

C’mon, it is obvious that the physician burnout is inversely proportional to administrative drag and panel size. That’s your answer. Idiots.

(And that is what is so great about Direct Primary Care).

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