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Declining Primary Practice: Why Primary Care isn't so "Primary"

Cortney Ikpe

Primary practice is often a term shrouded in ambiguity even within the healthcare industry.  In particular, we are referring to general practice physicians and healthcare professionals whom work in direct on-going care with non-referred patients. Despite its definition, it’s no secret that the number of specialized primary care physicians in the United States have significantly declined.

Fewer than 25 percent of new physicians in the United States go into primary care, and only about 5 percent open offices in rural areas - including J1 Visa Waiver physicians - according to a new study. In 2008, the Agency of Healthcare Research and Quality estimated approximately 624,434 physicians in the United States who spend the majority of their time directly with patients. Less than one third were specialized in direct patient primary care (eg, family practice physicians, pediatrics, geriatrics, internists, and general practitioners), yet handled over half of the near 1 billion visits to healthcare physicians paid by Americans.

There are nearly 210,000 primary care physicians currently practicing in the United States according to the American Medical Association Physician Masterfile. This averages to approximately 4745 visits per practicing physician a year (12-15 visits per day) as of 2010. With the nationwide population projected to increase 15.2% over the next 12 years (Bureau of Census population data), the workload per practicing physician will increase exponentially accounting for the tapered decline in available primary care professionals.

According to these projections, the US would need to produce over 50,000 new practicing primary care physicians in order to maintain the current workload and meet patient demand. The recent implementation of the ACA has provided several incentives to encourage the expansion of the primary care workforce. Despite these provisions, the number of generalized practitioners continues to gradually decline.