Is the primary care talent shortage decreasing American's lifespan?

By | February 19, 2019

A shortage of primary care providers and other health practitioners is already gripping certain pockets of the country, and the problem is only projected to get worse — which is especially distressing since PCPs generally prolong patients’ lives, shows new research.

Every 10 additional primary care physicians per 100,000 people in the U.S. was associated with a 51.5-day increase in life expectancy during the decade from 2005 to 2015, according to the study, which was led by researchers at the Stanford University School of Medicine and Harvard Medical School.

By comparison, the findings showed that an increase of 10 specialists per 100,000 corresponded to only a 19.2-day increase.

IMPACT

Nationwide, the researchers found that the number of primary care physicians has increased overall. But disproportionate losses of PCPs in rural areas, and overall population growth, has led to a decrease in the density of PCPs per 100,000 people from 46.6 to 41.4 per in that same decade. Rural populations were hit particularly hard.

The Association of American Medical Colleges estimates the U.S. will see a dramatic shortfall of primary care physicians by 2030.

The researchers said a lack of healthcare policies aimed at increasing primary care physician supply, compounded by market forces, have reduced the number of PCPs relative to higher-income specialties, such as cardiology and orthopedic surgery. Pay tends to be lower for PCPs, and the burnout rate higher.

When looking at PCPs’ impact on longevity, five major causes of death were considered: cardiovascular disease, cancer, infectious disease, respiratory disease and substance abuse or violence (such as death from alcohol and drug use, self-harm and interpersonal violence).

The association of PCP density with life expectancy was about one-fifth the magnitude of the association of poverty with life expectancy, and roughly two-thirds the magnitude of the association of tobacco with life expectancy.

Breaking that down to cause-specific mortality, the team found that an increase of 10 PCPs per 100,000 people was associated with a 0.9 percent reduction in cardiovascular mortality, a 1 percent reduction in cancer mortality and a 1.4 percent decline in respiratory mortality.

THE TREND

Many experts predict that demand for health services will soon exceed the industry’s capacity to provide care. The underlying reasons are a complex stew of aging Baby Boomers, physician burnout and the widespread closure of rural hospitals, not to mention the declining number of medical residency slots available to new graduates.

Telemedicine has been floated as a potential balm to this problem. The model is growing partly out of necessity, as generational shifts are resulting in more demand for technological solutions to care. And more physicians and clinicians are embracing the virtual care model as well, partly because it enables them to cast a wider net and regain a semblance of control over their workflows.

Twitter: @JELagasse

Email the writer: jeff.lagasse@himssmedia.com

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