A great irony of the coronavirus pandemic is that an infectious disease outbreak is actually causing many primary care clinics to close shop in the middle of a national medical crisis. I want to talk about why that is.

cc: @primarycarechat

The majority of primary care funding comes from billing insurance companies for office visits. While in-person visits are of great value in diagnosing and monitoring illness, this type of care represents only a fraction of our professional responsibility to patients.

As primary care doctors, we are responsible for answering medical questions, keeping medications refilled, monitoring for treatment side effects and disease complications, discussing lab and imaging results, filling out paperwork, and coordinating care with specialists.

However, we are only paid when we do these tasks during an office visit. When an outbreak of infectious disease prevents people from coming into the office, we continue doing this work because it is the right thing to do, but we stop getting paid for it.

Unfortunately many clinics cannot afford to pay rent and staff without the revenues of in-person office visits and so are being forced to shut down in the middle of the pandemic.

If your primary care provider shuts down, this means you have no one to refill medications, monitor labs, or contact with questions about disease management. Without a funding structure distinct from office visits to keep primary care practices open, you're left high and dry.

Your health insurance company of course continues to collect your premium payment each month, but you get no medical care to show for it.