Patients With Primary Care Doctors Receive Better Care, Study Says

February 12, 2019

Medical concept with stethoscope on keyboard

Patients with primary care physicians receive better healthcare, researchers say. According to a recent study published in the journal JAMA Internal Medicine, American adults with primary care doctors were more likely to receive high-quality healthcare compared to those without one.

Researchers analyzed over 70,000 U.S. adults who took part in the Medical Expenditure Panel Survey between 2002 and 2014. The nationally representative survey included the responses of 49,286 adults with primary care and 21,133 adults without primary care.

Researchers found that adults who receive primary care were more likely (78%) to receive high-value cancer screenings, diagnostic tests, and preventative tests compared to those without primary care (67%). This is significant considering 98,000 Americans die every year because of preventable medical errors.

Those who received primary care were also more likely to receive counseling and help with quitting smoking, which is the leading cause of preventable death.

“If you have a primary care relationship, you have a better experience with care, better access to care, and a 10% increase in things like high-value cancer screening, diabetes care, and counseling,” said lead author Dr. David Levine.

A primary care-first approach could improve U.S. healthcare, Levine says. Primary care physicians are familiar with their patients and are more likely to monitor blood pressure levels and provide flu vaccinations.

Primary care doctors can also provide weight loss programs or suggest activities like jogging or tennis, which can burn between 169 to 208 calories in 30 minutes. Activities like these are crucial with obesity-related cancers on the rise.

But researchers also found that, while primary care physicians were more likely to provide patients with high-quality care in some areas, both groups of patients had similar rates of low-value care. Patients with primary care were 11% more likely to receive medication errors related to antibiotics than those without primary care.

Despite similarities in low-value care in certain areas, up to 79% more patients with primary care rated their healthcare as excellent versus 69% of patients without primary care.

“Patients who don’t have this continuous relationship, and instead have fractionated care, lose out on high-value care and a better care experience,” said Levine. “We’ve seen a trend in people opting for less primary care suggesting that the American healthcare system doesn’t place much value on primary care.”

However, the problem may not be that Americans don’t value primary care but that they don’t have time to visit the doctor’s office.

Up to 45% of American adults between the ages of 18 and 29 don’t have a primary care doctor. Instead, they opt to visit urgent care centers because they’re faster and more convenient.

Ateev Mehrotra, an associate professor in the Department of Health Care Policy at Harvard Medical School, says younger patients are unwilling to wait a few days to see a medical professional for an acute problem, which used to be a routine situation.

“Now,” Mehrotra said, “people say, ‘That’s crazy, why would I wait that long?'”

Other patients may choose to forgo a primary care physician to avoid paying healthcare co-pays if they have healthcare at all. Up to 44% of Americans can’t afford an unexpected $400 medical expense.

Sacrificing health because of lack of funds can be seen in other areas, too. In fact, despite dentistry being one of the 10 most trusted professions in the U.S. and 90% of Americans agreeing that bad teeth can negatively affect one’s life, only 51% of Americans have received a dental cleaning in the last six months.

But if Americans are able to afford it, Levine suggests, they ought to invest in primary health care.

“[Our] study finds that the primary care relationship can lead to better quality care and a better experience for patients,” Levine said. “There’s more to healthcare than a one-time interaction that isn’t comprehensive. Having continuity that accounts for the whole person is much more important than anyone thought previously.”

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