(Reuters Health)—In a little over a decade, the number of patients in the U.S. with primary care providers dropped by 2%, a new study finds.
Between 2002 and 2015, fewer and fewer Americans of all ages, except for those in their 80s, had a primary care provider, researchers report in JAMA Internal Medicine.1
Although 2% may not seem like a big drop off, “that’s millions and millions of people who no longer have a primary care provider,” says the study’s lead author David Levine, MD, MPH, MA, an associate physician at Brigham and Women’s Hospital, Boston, and an instructor in medicine at Harvard Medical School. In fact, “it’s essentially about the population of New Jersey.”
“It’s a particularly stark decrease among younger folks, particularly those who are healthy,” Dr. Levine says, adding that the decline was also dramatic—at nearly 10%—among those who were in their 60s and healthy.
The study team found that, overall, the proportion of U.S. adults with a primary care physician fell from 77% in 2002 to 75% in 2015. Among 30-year-olds, the proportion dropped from 71% to 64% in the same period.
People with three or more chronic health conditions were an exception, and the proportion with a primary care doctor remained relatively stable, the authors note.
For Dr. Levine, primary care isn’t about healthy people getting an annual physical, it’s about having a relationship with a particular primary care provider, so that when you do get sick that doctor knows something about you.
“I tell my 20- and 30-year-old patients, ‘I don’t need to see you until you need to see me,'” Dr. Levine says. “It makes a big difference having a relationship with a physician even if you’ve met only once. Then the physician has some history on you, and maybe some baseline labs.”
Take the example of someone who has a urinary tract infection, Dr. Levine notes. “As a physician I’m going to feel much more comfortable treating you over the phone if I have baseline data,” he says. “And if the UTI doesn’t go away—if it becomes a kidney infection or is caused by a multidrug resistant organism—then I can follow-up.”
Beyond that, “[studies have shown] folks who have a primary care provider are much happier with their healthcare than those who don’t,” Dr. Levine says. “There is about a 10% boost in patient satisfaction with healthcare when they have a primary care provider.”
