Family physicians fill the unique role of providing comprehensive health care for patients of all ages. Unlike specialists, family physicians are not limited to treating one particular organ or disease. As a result, they are often the patient’s first point of contact for health concerns. Patients and family physicians often establish lasting and trusted relationships, which increases health plan retention and decreases hospitalizations. However, like much of the U.S., Arkansas faces a primary care physician shortage.
Workforce projections from the Robert Graham Center reveal that Arkansas will need an additional 410 PCPs by 2030 (a 23% increase compared to the current workforce) to maintain current utilization rates. Dr. William Joseph, a family practice physician at St. Vincent Primary and Convenient Care for over 30 years, understands the value of family medicine and its critical role in patients’ health care journey.
A Melting Pot of Specialties
Family practice physicians are unique in that they have a broad range of specialties they practice throughout their careers. “As a result of our training in a broad-spectrum of medical specialties,” Dr. Joseph says, “we are able to diagnose and treat many of the common medical problems that our patients have.” Because of the scope of services they provide, family practice physicians can often cultivate strong doctor/patient relationships with their clients. “If we are not comfortable treating a given problem, we advocate on behalf of the patients as we refer them to specialists that would be more capable of treating their complex problem,” continued Dr. Joseph.
Family practice physicians are unique in that they have a broad range of specialties they practice throughout their careers.
According to the American Academy of Family Physicians (AAFP), 82% of family practice physicians routinely perform procedures, including colonoscopies, endoscopies, family planning, suturing, and ultrasound imaging. In addition to diagnosing and treating illnesses, family practitioners also provide preventive care via health-risk assessments, immunization, screening tests, and routine checkups. Family practice physicians are dedicated to treating the whole person, promoting care coordination, and preventing unnecessary hospital visits.
The First Point of Contact for Rural Communities
Many Americans depend on family practice physicians more than any other medical specialty. Often, due to the focus on preventive care, family practice physicians are a patient’s first point of contact in rural communities. The AAFP estimates that around 87% of America’s family practice physicians participate in traditional Medicaid, and 78% accept new Medicare patients. “In our clinic,” Dr. Joseph says, “around 35% of our patients are covered by Medicare. About 25% have some form of coverage through the Affordable Care Act.” According to Dr. Joseph, the average primary care physician sees around 25 patients per day and works 4 to 5 days per week.
Many Americans depend on family practice physicians more than any other medical speciality.
Due to a large percentage of their clientele being in rural areas, especially in Arkansas, family practice physicians have begun utilizing telehealth services to accommodate patients’ struggles with transportation and access to clinics. “During the COVID-19 pandemic, we began engaging in more ‘virtual visits,’” Dr. Joseph says. “These are typically done via cell phone using FaceTime or GoogleMeet. Many medical problems do not typically require a hands-on examination and can be accomplished virtually.” Telehealth has allowed patients in rural communities to maintain a strong relationship with their doctors. Through telehealth services, family practice physicians can still encourage preventive care and perform annual wellness visits without having to see patients in the office.
Physician Shortage in Arkansas
Despite family practice physicians' benefits to the community, there remains a physician shortage in Arkansas and across the U.S. Arkansas has 75 health professional shortage areas throughout the state, where affecting more than 2 million people. According to Harvard University, the U.S. is facing the same troubles. By 2033, the U.S. will face a shortage of 21,000 to 55,000 primary care physicians.
The Association of American Medical Colleges reports that more than 40% of active physicians in the U.S. will be 65 or older in the next decade. Additionally, the American Medical Association reports that 29% of physicians retire between the ages of 60 and 65, and 12% retire before age 60. These reports reveal the need for students to pursue a career in medicine, especially family practice. Incentivizing students to do so, however, will have to start with reimbursement.
Family practice physicians have some of the highest overhead and lowest reimbursements of any subspecialty. “As a result,” Dr. Joseph adds, “the take-home pay for a family practice physician is at the lower end of the spectrum of reimbursement for all physicians.” Given the number of telehealth services they offer and the number of patients that rely on them for routine care, reimbursement rates should be on the higher end of the spectrum. While telehealth reimbursement rates have increased since the pandemic as we are seeing more of the benefits of telemedicine, reimbursement rates are still not where they need to be.
Family practice physicians have some of the highest overhead and lowes reimbursements of any subspecialty. As a result, their take-home pay is at the lower end of the spectrum of reimbursement for all physicians.
“CMS and private insurance companies will ultimately have to increase the reimbursement for family physicians to encourage more graduating medical students to pursue a career in family medicine,” Dr. Joseph suggests. “The average medical student has over $250,000 in debt when they finish their four years of medical school.”
Integrating Other Means of Care into the Primary Care Setting
Many researchers have considered integrating more specialty care, such as behavioral and maternal health, into primary care to compensate for the physician shortage. If primary care physicians who study and practice a broad range of specialties would provide more in-depth, focused care for a few patients, it may open the door for more patients to get the care they need. “Most family physicians develop certain specialty areas of expertise,” Dr. Joseph adds. “In doing say, they may provide more in-depth care in certain areas while providing a broad spectrum of care for all of their patients.” While many are still determining what this would look like, research is trending toward integrating other specialties into the primary care setting. It seems there is already a natural progression toward occasional specialty care in the primary care field.
Family practice physicians provide immense value to the community, especially with their broad range of specialties and the number of patients they serve each year. While we are facing a nationwide provider shortage, there are paths we can take that will increase the workforce and, in turn, increase the avenues to care that many people do not yet have. It all starts with a mutual understanding and willingness to serve our communities in the most efficient and effective ways possible.
For more information on important health care topics, follow AFMC on Facebook, Instagram, LinkedIn, Twitter, and YouTube.
Subscribe to our newsletter for the latest news and updates, including the most recent episode of AFMC TV.
