By Debra Wood, RN, contributor Aug 17, 2020
Fewer Americans rely on a primary care physician (PCP) for
their medical care than in past years, particularly younger individuals,
raising concerns among health experts.
letter published in JAMA Internal Medicine in December 2019 compared
differences in primary care from 2002 to 2015. The researchers found those with
a source for primary care declined from 77 percent to 75 percent, with
significant decreases among people in their 30s, 40s and 50s and for those
without chronic conditions.
A different study, reported in Annals
of Internal Medicine in 2020, studied primary care visit trends
among people insured through a national commercial insurer and found they made
24.2 percent fewer primary care visits in 2016 than in 2008.
A 2019 study
from the Kaiser Family Foundation indicated 45 percent of adults age
18 to 29 years did not have a primary care physician, and 26 percent of all
adults do not have one.
A Rand Corp. study
reported in 2016 many younger adults were using retail clinics, with 43 percent
of visits made by people age 18 to 44 years.
“Primary care is the keystone in a quality healthcare
ecosystem,” said Daniel Devine, MD, dual-board
certified internist and geriatrician and co-founder of Devine Concierge
Medicine in Wayne, Pennsylvania. “Primary care serves as the quarterback on a
healthcare team, ensuring patients’ successful navigation of the healthcare
system. Without a primary care physician, who is organizing and implementing
patient care plans?”
Additionally, “A PCP lowers the healthcare costs of an
average patient by 30 percent,” said Tom Koulopoulos, chairman and founder of
Delphi Group, a Boston-based think tank that advises Fortune 500 companies and
governments on future trends.
“Primary care physicians focus on disease prevention, obtain
vital screening tests, expedite workups, and engage patients to avoid
unnecessary emergency room visits or readmissions to the hospital,” Devine
Find locum tenens jobs in primary
care across the U.S.
What has changed in healthcare delivery?
A number of studies show that fewer patients, especially
younger patients, are choosing care from primary care doctors:
The retail healthcare market has continued its popularity in
the last few years. Walmart announced in June 2020 plans for expanding its
Walmart Health clinics, which offer primary care as well urgent care. And in
July 2020, Walgreens announced that it would open 500 to 700 full-service,
physician-led clinics in partnership with VillageMD.
Millennials are also drawn to telemedicine and online
“They regard face-to-face as an unnecessary inconvenience in
any case where online can be a substitute,” Koulopoulos said. “Millennials are
actually moving healthcare in the right direction by shifting a large portion
of healthcare to an online diagnosis and delivery model to the cloud.
Telemedicine, wearables and predictive analytics will make it possible to deal
with not just the millennial issues but the general lack of bandwidth faced by
PCPs who are increasingly dealing with panels of 2,000 or more patients with
increasingly more complex conditions as society ages.”Alternatives for primary care physicians
In addition to the changes in reliance on primary care
providers, the COVID-19 pandemic affected finances of primary care practices. A
in the September 2020 issue of Health Affairs
indicated between February
and May 2020, primary care offices lost $15.1 billion. Some may not survive the
pandemic. Higher overhead costs, fewer patients able to be seen in the same
amount of time and an aging physician workforce ready to retire could lead to a
decrease in primary care physicians.
by Merritt Hawkins in collaboration
with The Physicians Foundation released in 2020, learned 14 percent of
physicians plan to change practice settings as a result of COVID-19, and 18
percent plan to retire, temporarily close their practices or stop providing
As fewer people seek primary care, it could lead to a need
for fewer primary care doctors. There are alternatives to traditional practices.
Devine has found his niche as a primary care physician with
a concierge practice. He makes house calls, and supplements them with
“For this reason, we are seeing tremendous patient interest
in our model of primary care,” Devine said. “High quality primary care saves
both health systems and patients time and money.”
Another alternative is to transition to locums from a
full-time primary care practice. Staff Care consistently has hundreds of short-term
for primary care physicians
. Benefits include a housing allowance,
medical liability insurance and competitive pay.
Locum tenens provides opportunities to practice medicine
without the hassles of running a practice, managing staff and other stressors.
Dos’ Before Closing Your Medical Practice What Is
Locum Tenens? STAFF CARE
has hundreds of locum
opportunities for physicians and advanced practitioners in primary care and a
variety of specialties.
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