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The nation’s supply of primary care physicians is helping Americans live longer but a sliding “per capita supply” is a worrisome trend for U.S. population health, new research in the journal JAMA Internal Medicine shows.
The new JAMA Internal Medicine report showed just 10 additional primary care doctors per 100,000 people “was associated with reduced cardiovascular, cancer, and respiratory mortality by 0.9% to 1.4%.”
“Greater primary care physician supply was associated with lower mortality, but per capita supply decreased between 2005 and 2015,” Dr. Sanjay Basu of Stanford University and coauthors wrote in Tuesday’s JAMA report.
Primary care physician supply increased to 204,419 in 2015 from 196,014 in 2005. But the “mean density of primary care physicians relative to population size decreased from 46.6 per 100 000 population to 41.4 per 100 000 population with greater losses in rural areas,” the research showed.
“Across a number of analytic approaches, greater primary care physician supply was associated with improved mortality outcomes,” Basu and colleagues wrote. “The decrease in primary care physician supply across US counties from 2005 to 2015 may have important population health implications.”
The report comes as population health strategies are escalating from health insurers and government health programs as a way to help make sure patients get the right treatment in the right place and at the right time. This means primary care is critical to achieving reduced costs and better health outcomes.
In a commentary that accompanies Basu’s research, physicians stressed U.S. reimbursement of healthcare services and related “payment reform is key to attracting more US physicians into primary care training and practice.”
Some of the arguments in the commentary echo the arguments of groups like the Association of American Medical Colleges that for years have been trying to convince Congress to lift the cap on Medicare funds used to fund residency slots. AAMC data estimates there will be a shortage of between 7,300 and 43,100 primary care doctors by 2030.
“Payment reform is key to attracting more U.S. physicians into primary care training and practice,” the commentary by Drs. Sondra Zabar, Andrew Wallach and Adina Kalet from the New York University School of Medicine wrote. “Higher pay and lifestyle preferences lead most students to choose non–primary care fields, even when their hearts say primary care. Wemust reverse this trend with substantive changes in physician payment policy; no amount of superb primary care training or innovative practice reform will prevent further declines in primary care physician density, which will lead to worsening health for the United States.”
