Sticking with the same doctor over years can help your health. But finding the right doctor can be difficult.
If you want to stay healthy, picking a good primary care physician can be key.
In a report published last week, researchers found that American adults with primary care physicians are more likely to receive “high value” services such as regular cancer screenings, diagnostic testing, diabetes checkups, and counseling, compared to those without primary care.
These seemingly routine services can be lifesaving, especially in the case of cancer screening.
But for many people, finding a primary care physician to see on a regular basis can be difficult. The research authors hope by drawing attention to the long-term benefits of primary care, medical and government officials can take steps to improve access to care.
The report authors conducted what they call a first-of-its-kind comparison study by quantifying the experiences of 49,286 adults with primary care and 21,133 adults without. They wanted to see how Americans with similar health status, demographics, and other factors answered when asked about those primary care visits, including questions on the “four C’s” of primary care: first contact, comprehensive health care, and continuous and coordinated care.
Those with primary care reported better patient experience and overall healthcare access compared to those who didn’t see a primary care physician regularly, according to the study, which was published in the Journal of American Medical Association Internal Medicine. Researchers said those experiences remained stable from 2002 to 2014.
“People who have primary care are fundamentally different from those who do not; they tend to be older, better insured, more white, etc.,” said Dr. Jeffrey Linder, senior study author and chief of general internal medicine and geriatrics at the Northwestern University Feinberg School of Medicine, in a Northwestern news report.
“Our advance was to look at healthcare for Americans who were otherwise as similar as possible — but did or did not have primary care.”
Linder said the results validated what primary care physicians have known all along about the importance of consistent care when it comes to prevention. He and the co-authors of the study conclude the results should show why policymakers and health systems should consider increasing investments in primary care.
Other studies have found that while the United States spends the most on healthcare, a small amount goes into primary care compared to specialty care services.
While preventative care is often touted as a major goal in the U.S. healthcare system, the system and the way the insurance market is set up makes that goal a challenge for patients to access primary care physicians.
While an annual physical is covered with minimal or no co-pay by many health insurance plans, some patients may have high co-pays when they visit their primary care doctor for other concerns. Others may have high deductibles, meaning they’ll have to shell out hundreds of dollars before their insurance starts to cover doctor appointments.
“Let me point the finger at ourselves,” Linder said. “We make access (to care) way more challenging than it needs to be. I think the reason why we’re not as accessible is the way we’re paid for health care. You still get paid by and large when you see someone in person.”
In addition, on the provider side, young medical students are more likely to go into specialty care instead of primary care. The incentives to go into family medicine, for example, are few and those physicians are even less likely to practice in rural areas.
A report published by the Association of American Medical Colleges estimated a shortfall of between 14,800 and 49,300 primary care physicians by the end of 2030.
“I think if we want to address the shortage, we need to put more money in to encourage the market,” Linder added. “We reward high cost specialty procedures much more than people who do cognitive medicine.”
Dr. Sterling Ransone, a practicing family physician in Deltaville, Virginia and member of the board of directors of the American Academy of Family Physicians, said he returned to his rural hometown to practice. Ransone said he understands not every young physician out of medical school and in debt can do that.
He was not surprised by the results of the study that found patients with consistent primary care are likelier to receive high-value and personalized care.
He pointed out that because he’s known his patients for years, he sees their whole health history and understands how to navigate their care better. But Ransone agreed that access to primary care remains challenging, for both doctor and patient.
“I wish I could spend more time seeing patients, but the way the system is designed, it’s all about efficiency and volume,” he said.
For every hour he sees a patient, he estimates he has two hours of administrative work.
“Unfortunately, in the U.S., the way our system is set up, there are no incentives for folks to see their primary care doctor,” he said. “Getting to know someone over a long term is beneficial for that person, and for a physician is great.”
The findings also found, however, that patients with primary care were also more likely to receive care that may be supplemental and may not actively help their health, such as getting unnecessary antibiotics.
Both Linder and Ransone said that, too, needed to improve.
“We have further work to do to optimize the amount of high-value care and minimize the amount of low-value care we are delivering to patients,” Linder said.
Both Linder and Ransone also offered several recommendations on how to find a primary care doctor:
- Talk to your friends and see who they trust.
- If the doctor you want isn’t listed in an insurance network, call that doctor’s office and check. Sometimes a physician’s name is accidentally left out.
- Check to see how easy it is to contact the doctor during office hours and after hours.
- Look at the hospital the doctor is affiliated with and ask: Is it a hospital that you like?
- Set up an appointment to sit and talk with the doctor. Ask yourself: Does this person sound like the right physician for me?