Policymakers should stop making assumptions about how many patients a physician can see
FOR IMMEDIATE RELEASE: Monday, July 11, 2016
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WASHINGTON, DC — Policymakers should drop the generally accepted assumption that primary care physicians can reasonably care for a patient panel of 2,500 people. That assumption fails to accurately reflect reality, results in imprecise estimates of the primary care physician workforce and can result in policies that don’t meet patients’ needs for care.
That’s the conclusion of an analysis about primary care physician patient panels by Melanie Raffoul, MD, past fellow at the Robert Graham Center for Policy Studies in Family Medicine and Primary Care. Raffoul also is assistant professor and attending physician at New York University Langone Medical Center.
“The appropriateness of the traditionally cited primary care panel size of 2,500 patients per physician does not appear to be borne out in either study or practice,” writes Raffoul in “A Primary Care Panel Size of 2500 Is Neither Accurate Nor Reasonable(www.jabfm.org)” in the July/August Journal of the American Board of Family Medicine. “Our review suggests that current panel sizes in primary care are closer to 1,200 to 1,900 patients per primary care physician.”
As demand for primary care increases, physicians may feel pressured to accept more patients. Noting expanding panel size may be possible when using care teams or panel managers, increasing telecommunication between physicians and patients, or delegating appropriate tasks to non-physician clinicians, “research has not yet documented that PCPs can provide recommended care to a patient panel in the range of 2,500,” she writes.
In fact, studies consistently show that smaller patient panels result in better, more comprehensive care that meets patients’ expectations, Raffoul says. However, smaller patient panels mean the health workforce will need more primary care physicians.
Such variations are important to physician workforce planning, according to Raffoul. Panel size “can change estimates significantly,” she writes. One recent study found that the primary care physician shortage billowed from 33,000 to 60,000 when an assumed patient panel of 1,400 patients per physician was decreased by 10 percent. By contrast, the primary care physician shortage plummeted to 6,000 when the patient panels grew by 10 percent.
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.