Are Primary Care Physicians Going Out of Style?
By Phillip Miller
The Health Care Cost Institute (HCCI) recently released a report that quantifies how the traditional physician office-based model of primary care is changing.
According to the report office visits to U.S. primary care physicians declined by 18% from 2012 to 2016.
Are Americans getting healthier or have they for some reason become disinclined to see primary care physicians?
Not even close. The real answer is that there are simply not enough primary care physicians to go around. The study cites the physician shortage as a key reason for the decline. According to Amanda Frost, Ph.D, senior researcher at HCCI and lead author of the report, ”Patients may increasingly see nurse practitioners and physician assistants as a substitute for primary care physicians, especially in areas with PCP shortages where scheduling an office visit to a PCP is more difficult.”
The report notes that while visits to primary care physicians dropped, office visits with NPs and PAs increased by 129% from 2012 to 2016.
You might think these two divergent trends would result in primary care physicians being less busy than they once were, but statistics from the Survey of America’s Physicians suggest otherwise. This national physician survey, which Merritt Hawkins conducts every other year for The Physicians Foundation, asks doctors to describe their activity levels. In 2012, 75.5% of physicians said they were either at capacity or overextended and unable to see more patients. In 2018, the number increased to 79.5% (80% for primary care physicians), despite the growth in NP and PA visits.
Moreover, in 2018, family medicine was Merritt Hawkins’ number one most requested type of search for the 12th year in a row, with internal medicine close behind at number three. When combined, NPs and PAs were our third most requested type of recruiting assignment, though they were not in our top 20 six or seven years ago.
Demand for primary care services is so strong that primary care physicians, NPs and PAs are all the targets of aggressive recruiting by hospitals and a growing number of settings that provide “convenient care,” including outpatient clinics, urgent care centers, retail clinics and Federally Qualified Health Centers (FQHCs). Changing delivery models that emphasize team-based care and population health management also drive the need for more primary care physicians, NPs and PAs.
When it comes to primary care physicians and advanced practice professionals such as NPs and PAs, it’s not a question of “either/or” in today’s market….it’s both.