Research: Complexity of Primary Care Physician Office Visits Is Higher than for Subspecialist Physicians

FOR IMMEDIATE RELEASE: Monday, Feb. 8, 2016

Leslie Champlin
Senior Public Relations Strategist
(800) 274-2237, Ext. 5224 

WASHINGTON, DC — Primary care physicians provide far more complex care, as measured by the number of conditions addressed per visit, when they see patients with diabetes and other health problems than do subspecialists, according to researchers at the Robert Graham Center.

Robert Graham Center economist Miranda Moore, PhD, and her colleagues measured the number of health conditions addressed by primary care physicians in a single patient visit and compared them to the number of conditions addressed by subspecialists. Their results, published in the February issue of Primary Care Diabetes(, showed that nine out of 10 visits with patients who have multiple diagnoses at the visit were with primary care physicians. By comparison, seven out of 10 visits by patients with a single diagnosis were to subspecialists.

Overall, complexity of the office visit for primary care physicians, as reflected by the number of visit diagnoses reported, was higher than for subspecialist physicians, the researchers found.

“When patients think about their overall health, they think about their primary care physician,” Moore said. “When they think about individual conditions, they think about their subspecialist.”

The findings have implications for payment policies as the U.S. health care system moves away from paying for volume and toward paying for the value of services, according to Moore. The complexity of care within a single office visit will need to be recognized and more accurately compensated.

“As we move forward with changing the way we pay for care, we need to look at the breadth of what’s being addressed within each office visit to measure complexity,” Moore said. “We need to consider various measures of the complexity of care physicians provide in a single visit.”


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.