The entire system’s viability hinges on the ability of primary care providers to absorb not only 40 million new patients, but a huge increase in visits by existing patients who should have been seeing a family physician in the first place rather than going to a specialist or emergency room. Conventional wisdom would conclude that adding more patients to an already crowded primary care system would result in less access to care for everyone. That will only be true if primary care providers refuse to make relatively simple changes.

By instituting reforms in their individual practices to streamline operations, elevate nurses and escape their time trap, primary care providers can reclaim their place as the “familiar physician,” the first and best source for health care for the vast majority of Americans. This transformation allows the physician to spend more focused time with patients and also allows more quality appointments to be fitted into the schedule because the physician spends less time doing administrative work.

A familiar physician gives the best care in terms of quality and cost effectiveness. She sees her patients regularly, knows their problems and enjoys their trust. Because a familiar physician knows her patients, the costs for the care provided are much lower. Her patients are less likely to visit the emergency room for routine problems, and the physician is less likely to order unnecessary tests; both are major reasons health care costs are out of control.