HealthDay explores the growing shortage of family physicians in the United States. A new HealthDay-Harris Poll finds Americans know the value of having a family doctor, but sometimes find it difficult to access care.
Dennis Thompson, Managing Editor, HealthDay
It's frustrating when you're sick and you can't get an appointment with your doctor, or even worse, you can't find a family doctor taking on new patients. More Americans are running into these issues according to a new Health Day Harris Poll.
Joining me today is Kathy Steinberg, Vice President of Healthcare Research for the Harris Poll, and Dr. Jennifer Brull, Board Chair of the American Academy of Family Physicians. Thank you for joining me today.
To start off, what were the findings that most stood out to you from the survey? What did you think was most important?
Kathy Steinberg, VP, HealthCare Research, The Harris Poll
First of all, thank you so much for having me. It's been a pleasure partnering with you on this research.
What we learned was that most Americans still have a family doctor. They recognize the value of family medicine, but there's barriers to getting a family doctor for those who want one.
And even for those who have a primary family doctor, they still sometimes experience barriers in accessing the care that they need when they need it.
So, I would say that family medicine is still important and valued to health care consumers, but there are systemic and logistical barriers that prevent them from occasionally accessing the care that they need.
Jennifer Brull, MD, FAAFP, Board Chair, American Academy of Family Physicians
Well, I'm going to agree with Kathy completely that family doctors are very important in this equation. And I think the thing that stood out to me is a reaffirmation of what we are seeing in our offices every day.
We know that there are patients who need us. We know that there are patients who we already know about on our panels who need better access and patients that we don't know about who live in our communities who are trying to reach care that aren't able to do so.
This bears out what the AFP has known about the shortage of family physicians and other primary care clinicians in the United States, which just continues to worsen.
Dennis Thompson, Managing Editor, HealthDay
Lots of people in the survey said that they have a family doctor, but then said they've had trouble seeing them or even had to resort to urgent care. What explains this discrepancy, Dr. Brull, between having a doctor in name, but maybe not in practice?
Jennifer Brull, MD, FAAFP, Board Chair, American Academy of Family Physicians
Family physicians today are caring for a growing number of patients on their panel. These people are identified as their patients perhaps through an insurance or an employer program. And yet there just isn't space on the physician's calendar to see all of the patients that are attributed to them or who claim them as their own.
Some of this comes in terms of just the number of patients there are, but much of it comes in terms of the growing administrative burden of caring for patients.
Most physicians spend almost as much time charting, doing prior authorizations, reaching out and trying to find consultant notes and closed loops as they do in actually seeing patients face to face.
So, a lot of that explains why patients have doctors but can't see those doctors.
Kathy Steinberg, VP, HealthCare Research, The Harris Poll
And as I mentioned, more than just over half of adults who have a family doctor agreed that even though they have a provider, they're still sometimes unable to get care when they need it due to lack of available appointments, inability to reach a receptionist, long waits for an appointment time.
We asked adults who don't have a family doctor, who or what do you turn to when you need medical or healthcare instead? And I don't think it'll come as surprise to anyone that the number one answer was urgent care. The number two answer was ER or emergency room or emergency department.
But what I found shocking and concerning is nearly 30%, 29 % of those who don't have a doctor, said none. They just don't get care from another source when they need it. So that's a lot of unmet needs
Dennis Thompson, Managing Editor, HealthDay
And then obviously the contrary point is since it can be hard to access your primary care doctor or even find one, why shouldn't people just go to urgent care or walk in clinics for their regular medical care? What's the benefit, Dr. Brull, of having a family doctor?
Jennifer Brull, MD, FAAFP, Board Chair, American Academy of Family Physicians
I don't think you need an expert to tell you the benefit to having a partner in your life and your health is that that partner knows you a whole lot better than someone that you are meeting for the first time in an urgent care center.
They're going to be aware of your chronic conditions, your past medical history, the medications you're taking. Even if you can't remember all of them, they're going to. And this prevents a lot of downstream complications.
Urgent care and emergent care fill important gaps…there are times and places when they are entirely appropriate. And for those conditions that are best served by seeing a primary care physician in an office, being able to see your primary care physician or your family physician means that the cost is lower, the hassle is lower, and likely the overall outcome in care is better.
Kathy Steinberg, VP, HealthCare Research, The Harris Poll
And our survey bore this out. saw more, nearly nine in 10 Americans, regardless of whether they have a provider or not, agreed that it is important to have an ongoing relationship with one primary care doctor who oversees your medical care. And more than half strongly agreed with that statement.
Those who are more likely to agree with that statement are the ones who need care the most. Older adults, those who are already living with a chronic care condition, and ones who already have a family provider.
So, they recognize that value and they went out and met that need.
Dennis Thompson, Managing Editor, HealthDay
Now, I noticed that in terms of being able to find a doctor, bout two in five said that they might find a doctor that they like, but the doctor either isn't accepting new patients or doesn't take their insurance.
What's driving these barriers and is there any way around them, Dr. Brull?
Jennifer Brull, MD, FAAFP, Board Chair, American Academy of Family Physicians
So, the reason for the growing shortage of family physicians and other primary care clinicians is multifactorial. It is not just one thing. We have a very large generation of family doctors who were part of the baby boomers who are reaching the age of retirement.
Unfortunately, they are leaving the workforce in addition to a significant number of family physicians who are experiencing burnout and leave clinical care because of that burnout…or leave clinical medicine for other spaces or even completely different roles.
And the rate at which people are leaving family medicine and primary care in general is exceeding the rate of those entering family medicine, even though that number has gone up year after year for more than 16 years. So, we have a historic problem in which the value of primary care physicians is under recognized and underpaid and this is driving a shortage of clinicians.
This means, of course, that patients are experiencing this lack firsthand.
I do want to say that the AAFP is working to grow the family medicine workforce to ensure that all Americans have access to primary care in their communities. We know that we're going to need about 40,000 more primary care physicians by the year 2036, which is a really scary number.
And so, we are working on the legislation, the advocacy and the tools to try to grow our workforce to begin to meet that need.
Dennis Thompson, Managing Editor, HealthDay
So based on the barriers noted in this survey, what would you recommend for people who are having trouble finding a doctor? What should they do?
Jennifer Brull, MD, FAAFP, Board Chair, American Academy of Family Physicians
I think that patients who do not have a family physician or another primary care clinician should put this on their to-do list to check off, even if they are healthy in this moment and they can't imagine why they would need to see a doctor in the future.
Part of having a doctor when you need one is establishing that relationship before you need one. And this means doing a little bit of homework.
Certainly, the survey respondents would tell you they looked at what their employer sponsored insurance recommended, who were a list of doctors that were in plan. And maybe they did a little bit of look on the web around what does the world think about those doctors or what does this community think about those doctors?
And then you got to make that appointment and you need to go see them, even if all you're doing, this I'm using all in a little bit of a small space here, which is it's actually a really big thing you're doing, is establishing care with that clinician and making sure that you do have a good fit.
Dennis Thompson, Managing Editor, HealthDay
Are there any points, Kathy or Dr. Brull, that I've missed that you think would be very, very important to get into this first kind of patient-centered article for this series we're doing?
Kathy Steinberg, VP, HealthCare Research, The Harris Poll.
Everyone's a patient. Everyone is a health care consumer. Just need more guidance on how to find the right provider and get the care that they need.
Jennifer Brull, MD, FAAFP, Board Chair, American Academy of Family Physicians
And I would just wrap up by saying thank you so much for inviting me to come talk to you. Family physicians take care of humans from birth until death, literally, and pregnant people too. And so, it's really nice to be involved in this conversation around the critical importance of primary care and family medicine in specific.
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