Primary care 2019 vs. 1989

There’s been at least a 200-300% increase in care complexity between when I started medical practice and today. Many new classes of medications for fairly common disorders, many more specialty interventions that may be considered.

At the same time computer based clinical decision support systems have been a surprising failure. (Emily uses Epic, I use VistA/CPRS). In the 90s we expected far more than we actually got.

We are asking a lot of the modern primary care physician.