If you can’t find a primary care doctor or can’t get an appointment when you need one, you might wind you paying with your health. In HealthDay’s continuing series of the family doctor crisis in the U.S., Managing Editor Dennis Thompson talks to Sophia Tripoli of Families USA.
Dennis Thompson, Managing Editor, HealthDay
If you're struggling to find a primary care doctor or you can't get an appointment when you need one, you might wind up paying with your health. Today in Health Day's continuing series on the family doctor crisis, Sophia Tripoli of Families USA discusses what can happen without consistent primary care.
Thanks for your time, Sophia.
Sophia Tripoli, Managing Director, Health Policy, Families USA
Thank you very much for having me.
Dennis Thompson, Managing Editor, HealthDay
What can happen to a person's health if they don't have a family doctor or can't get in to see their doctor?
Sophia Tripoli, Managing Director, Health Policy, Families USA
One of the things that can happen, which is one of the most consequential things for a person, is if they can't get in to see their doctor, we know that consumers and patients and families across the country delay care, often getting sicker and sicker until they are so sick that they have to go to the emergency room, which is one of the most expensive care settings.
And sometimes when they can't get in to see their doctor, instead of just delaying care, they skip it altogether. And so, they are very, very serious health consequences for people when they can't get access to the doctor when they need it.
Dennis Thompson, Managing Editor, HealthDay
So, which of a family doctor's regular duties most contribute to their patient's long term health?
Sophia Tripoli, Managing Director, Health Policy, Families USA
We know one of the things for primary care that's so important is the time of being able to be in person and spend time with your patient documenting and discussing their medical history and taking the time to understand all the different factors that are going into somebody's health outcomes and health consequences from their environment, from their community, etc.
And unfortunately, in our healthcare system, clinicians and providers and primary care docs have so much demand for their time, that they're so squeezed for patients, time with patients, that process can often feel rushed. It’s often under-reimbursed or in some cases not reimbursed at all.
And so, the physicians and primary care doctors have to just do that work anyways and build it in.
And I would say it's one of the areas where we're seeing so much increased demand and pressure, and to meet the needs of a of an evolving health community, that it's creating a lot of pressure and undue pressure and burnout, frankly, in the physician community.
Dennis Thompson, Managing Editor, HealthDay
So, docs have to worry about prevention and they also have to worry about managing chronic diseases, both of which can really take up a lot of their time.
Sophia Tripoli, Managing Director, Health Policy, Families USA
Absolutely. Prevention is one of the most important things to keeping people healthy and making sure that we're man effectively managing health outcomes across an individual but also a population.
And it's one of the things that we know is so important for keeping people out of urgent care centers, out of hospital centers, out of emergency room departments and so prevention is an incredibly important function and clinical service that these providers play as well as addressing this growth of chronic illness in our country.
And so all of these complexities and conditions we expect and we want primary care and physicians to be able to manage with their care teams. and there's a lot that on their plates and being able to being able to do this effectively.
Dennis Thompson, Managing Editor, HealthDay
And then on top of that, they have to step in and coordinate care during a medical problem. If someone, say, is diagnosed with cancer or some such.
Sophia Tripoli, Managing Director, Health Policy, Families USA
Absolutely. And care coordination is an incredibly important function of going to see a doctor, right.
And not just the doctor, but the care team, the nurses, the nurse practitioners, social workers in some cases, other types of allied health professionals that are part of that wraparound team around a patient.
Dennis Thompson, Managing Editor, HealthDay
So, doctors essentially are being asked to do these key functions without consistent reimbursement?
Sophia Tripoli, Managing Director, Health Policy, Families USA
I think in in many ways that's true and certain types of providers experience that more than others.
Primary care in particular, I would say, is a type of provider that is historically been under undervalued in our healthcare system, under reimbursed in our healthcare system, and yet we expect everything from them.
It's the bedrock of a high value, high functioning healthcare system, and yet we don't pay nearly as much as we should at the clinicians and the provider level.
And as a country, we spend about five percent of total healthcare spending, right?
We're spending trillions of dollars year ever year on healthcare. and only five percent of that goes to primary care.
So, it gives you a sense, a way to calibrate how we prioritize and invest in our healthcare system the importance of prevention and chronic disease management and the role that primary care doctors in particular play in our healthcare system.
Dennis Thompson, Managing Editor, HealthDay
Do we have any idea how much lack of access to primary care is impacting Americans' longevity and health?
Sophia Tripoli, Managing Director, Health Policy, Families USA
There is some evidence and the specific numbers I don't have at my fingertips. We do see one of the problems with sort of undervaluing and under-reimbursing, underpaying primary care is burnout in the field, but also some of the workforce shortages.
And as you mentioned up top, when folks can't access their provider, especially their primary care provider, they delay care, they go see a specialist, they delay or forego it altogether, they show up in the emergency room.
And so, we really need to flip that paradigm in terms in our healthcare system and put the resources in the in the front end to in the prevention, in the wellness, in the health management, so that we can prevent some of these long time long term negative health consequences, as well as keeping folks out of some of the most expensive care settings where they ultimately end up when they can't get access to the provider up front.
Dennis Thompson, Managing Editor, HealthDay
Thank this has been great, Sophia. Thank you so much for joining us.
Sophia Tripoli, Managing Director, Health Policy, Families USA
Thank you very much for covering the issue.
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