4/14: Primary-Care Physician Report
CSMS releases state’s 1st primary-care physician survey
Primary-care shortage threatens patient access to care
The Connecticut State Medical Society today released the results of the state’s first study of the primary-care physician workforce in advance of its publication in the May issue of the peer-reviewed journal, Connecticut Medicine. The Connecticut 2009 Primary Care Survey: Physician Satisfaction, Physician Supply and Patient Access to Medical Care is based on a self-administered online survey from October through December 2009. Four-hundred ninety-eight physicians from three medical specialties participated: family physicians, who care for patients from birth through old age; internists, whose practice focuses on adults; and pediatricians, who care for newborns through adolescence.
The results reveal that Connecticut’s primary-care capacity is already stretched very thin: 28% of internists and 26% of family physicians were not accepting new patients. In addition, on average, new patients faced a wait of 18 days for a routine office visit. The addition of currently un- and underinsured patients to the patient load would be expected to stretch urban areas’ physicians and overwhelm those in rural areas if structural issues are not addressed.
“These results of the study are exactly the reason why we thought it was important to take a detailed look at Connecticut’s primary-care situation today,” said CSMS President Kathleen A. LaVorgna, MD. “This report tells us that Connecticut has a limited capacity to care for more patients who require primary-care services, and the clock is ticking.”
Half of the respondents reported that obtaining referrals to specialists for their patients had become more difficult over the past three years. Health-plan restrictions were the most significant reason cited for this difficulty, followed by the supply of physicians in specialty areas.
Family physicians and internists were very dissatisfied with the administrative requirements of practicing medicine. Twenty-five percent of family physicians and 22% of internists said they were contemplating a career change because of the practice environment in Connecticut. In contrast, pediatricians were the most satisfied with the number of hours they worked; with the Connecticut malpractice environment for their specialty; with the administrative requirements for practicing medicine; and their net incomes as physicians.
“Practicing medicine today differs dramatically from the way these physicians were trained,” said report co-author and CSMS Executive Vice President Matthew C. Katz. “They are spending more than 40 hours a week providing direct patient care before they start dealing with insurance-company red tape and other bureaucratic issues. These other issues are forcing many physicians to think about career changes and moving out-of-state.
“The only substitute for a primary-care physician is another primary-care physician,” Katz said. “The key is finding the right incentives to keep our existing primary-care physicians here while also making out state inviting for new physicians.”
CSMS has long espoused student-loan forgiveness and forbearance as ways to bring new physicians to Connecticut for extended periods of time. Medical malpractice reform, and removing some of the barriers to physician care erected by insurance companies would also help.
“It has been well documented that we have a shortage of primary-care physicians in Connecticut and across the country,” said Dr. LaVorgna. “Connecticut policy-makers need to develop incentives to draw new physicians to our state before we are in crisis, because 49 other states will be vying for the same young physicians.”
The survey was conducted through the assistance of the Connecticut Chapter of the American College of Physicians, the Connecticut Chapter of the American Academy of Pediatrics and the Connecticut Academy of Family Physicians. United Health Care Foundation of Connecticut funded the project, which also examined the potential impact of the medical home model on the Connecticut primary-care situation. That issue will be the subject of additional reporting in the weeks ahead.
Robert Aseltine, PhD, a professor at the University of Connecticut Health Center, served as lead researcher and co-authored the study. CSMS Director of Communications Audrey Honig Geragosian was also a co-author. The Connecticut 2009 Primary Care Survey is a follow-up to the CSMS 2008 Physician Workforce Survey.
The Connecticut 2009 Primary Care Survey: Physician Satisfaction, Physician Supply and Patient Access to Medical Care will be posted here concurrent with its publication in the May 2010 issue of Connecticut Medicine. Interested reporters may contact Audrey Honig Geragosian to obtain a pre-release of the report for purposes of news coverage.
Last Updated ( Wednesday, 07 July 2010 )