By Michael E. Cain, M.D. and Marsha L. Lewis
For most consumers, primary care is the most important part of the health care system. But in upstate New York and especially in Western New York, it is increasingly difficult for people to get through that door.
Recent statistics estimate that in 2013, there were 57 primary care physicians per 100,000 people in New York’s westernmost counties, far lower than what’s considered sufficient at approximately 80 per 100,000.
The Affordable Care Act is boosting the number of people seeking medical care in the state by about 1 million. The number of primary care physicians is clearly going the wrong way.
Worthy proposals to address the problem have appeared on the federal and state levels. But additional fixes are in our own backyard.
In our view, primary care is the responsibility of teams of health care professionals, including physicians and nurse practitioners who provide primary care for all populations. For example, University at Buffalo medical and nursing faculty work together, providing primary care and training for health care professionals at sites like the New York State Indian Health Service and Lakeshore Behavioral Health with homeless and severely mentally ill populations.
Other health professionals, such as dentists, should play an important primary care role, providing chairside screening for hypertension, diabetes or oral cancer. Pharmacists also play key roles, addressing medication needs and contraindications.
These advances are happening in part because of groundbreaking research at UB, where faculty are funded to study and provide solutions to the primary care crisis. Within UB’s five health sciences schools, we have embraced interprofessional education, where students in all programs of our academic health center learn to practice “patient-centered care,” working in teams across the health disciplines with an emphasis on preventive care.
In UB’s state-of-the-art Behling Simulation Center, simulations provide non-threatening learning environments, where students learn how to work together. UB students from nursing, medicine, dental medicine, pharmacy, physical therapy, occupational therapy, social work, public health and other fields work collaboratively to ensure the best patient outcomes.
Each year, UB graduates more than 1,000 health professionals. When they start their careers, they bring this new culture with them, strengthening the team approach to primary care. All of UB’s health professionals are applying the team approach to improve the primary care, and the health, of all Western New Yorkers.
Michael E. Cain, M.D., is dean of the School of Medicine and Biomedical Sciences at the University at Buffalo. Marsha L. Lewis, Ph.D., is dean of the School of Nursing at UB.