Facilities Overtake Individual Clinicians as Patients’ Usual Source of Health Care
FOR IMMEDIATE RELEASE: Tuesday, Dec. 15, 2015
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WASHINGTON, DC — The number of Americans who say their usual source of health care is a facility rather than a specific clinician has increased, a worrying sign that fewer people are reaping the benefits of a continuous relationship with a personal physician, according to findings in research by the Robert Graham Center for Policy Studies in Family Medicine and Primary Care.
The research, “Fewer Americans Report a Personal Physician as Their Usual Source of Health Care” by Robert Graham Center researcher Anuradha Jetty, reveals that an increasing number of people over the past 16 years, cited a facility rather than an individual clinician as their usual source of care, and only 60 percent report any usual source of care at all. The report was published in the Dec. 15 American Family Physician.
That data are troublesome, according to Jetty, because research consistently shows that people who have an continuous caring relationship with a physician have better health and fewer health care-related costs.
“There’s a concern that if you’re seeing different providers, even within the same facility, you lose some of the advantages of continuous relationships,” she said. “Research suggests that seeing the same clinician over time increases trust, awareness, and effectiveness of care, and is associated with better quality at lower cost. We don’t know yet if the same effects result from thinking of a facility as your usual source of care.”
Jetty analyzed Medical Expenditure Panel Survey data from 1996 to 2012 to identify trends in where Americans got their health care. She found that the percentage of people who reported a usual source of health care declined slightly over that period. More striking, the report says, is the increase in the number of people who did have a usual source of care but said that care was provided by a facility rather than an individual physician.
“Declines in the percentage of people reporting an individual clinician as their usual source of care was countered by a nearly equivalent rise in those reporting a facility as USC,” she wrote.
Whether the trend reflects changes in the health care system is yet to be determined, according to Jetty. As team-based care becomes more prevalent in the patient-centered medical home, patients may see nurse practitioners, physician assistants as well as physicians, depending on their health need. Moreover, more family physician practices have added electronic communications to their patient services. Data from the American Academy of Family Physicians practice profile survey show more than half provide a web portal for secure messaging with patients and for prescription refill requests. More than four in 10 respondents use email communication with their patients and provide online appointment scheduling. More than a third provide 24-7 electronic health record access for real-time care.
“The advent of patient-centered medical homes, broader primary care teams, and increased virtual contact may help to explain these findings and represent opportunities for improved outcomes,” Jetty wrote. “This important topic deserves further research and is well-worth the attention of healthcare stakeholders and research funders.”
About the Robert Graham Center
The Robert Graham Center for Policy Studies in Family Medicine and Primary Care works to improve individual and population health by enhancing the delivery of primary care. The Center staff generates and analyzes evidence that brings a family medicine and primary care perspective to health policy deliberations at local, state, and national levels.
Founded in 1999, the Robert Graham Center is an independent research unit affiliated with the American Academy of Family Physicians (AAFP). The information and opinions contained in research from the Center do not necessarily reflect the views or policy of the AAFP.