To take a closer look at how many patients have a primary care provider, Dr. Levine and his colleagues turned to a nationally representative database of health spending that surveys between 21,915 and 26,509 patients annually about their experiences with healthcare.
The researchers focused on the years 2002 through 2015 and deemed patients to have primary care providers if they answered yes to four questions: Do you have a usual source of care for new health problems? Do you have a usual source for preventive health care? Do you have a usual source for referrals? and, Do you have a usual source for ongoing health problems?
“It’s a very patient-centered definition of primary care,” Dr. Levine says.
Given the current system of healthcare, the new findings aren’t necessarily a cause for worry, said Martin Makary, MD, of the Johns Hopkins Bloomberg School of Public Health, Baltimore, author of The Price We Pay: What Broke American Health Care—and How to Fix It.
“With the primary care provider shortage, do we really need every young healthy male coming in to see their doctor regularly?,” Dr. Makary says. And even though “relationships are powerful, turnover in primary care is extremely high.”
The real problem, Dr. Makary says, is with the traditional fee-for-service billing model and the low value placed on the provision of primary care.
The value of primary care has also been limited due to the fact that most providers can only afford to do very short visits, Dr. Makary says. And although primary care providers used to spend a lot of time educating patients, these days people “are bypassing traditional models and educating themselves.”
Reference
- Levine DM, Linder JA, Landon BE. Characteristics of Americans with primary care and changes over time, 2002–2015. JAMA Intern Med. 2019 Dec 16. doi: 10.1001/jamainternmed.2019.6282. [Epub ahead of print]