A new Health Affairs report found that primary care physician (PCP) jobs grew at a much slower rate than specialists. PCP jobs increased 8% between 2005 and 2015, while specialists grew by 48%. The percentage of physicians in primary care dropped from 44% to 37% in that time.
In some cases, non-physician primary care providers, such as physician assistants and nurse practitioners, have filled in the primary care gaps. However, the authors said that overall the total primary care workforce grew 17% when those two jobs are added, which is still slower than the growth of specialists.
The report suggested that slower primary care growth could lead to higher healthcare costs and problems with access to care as the nation ages and more Americans have health insurance than a decade ago.
Primary care physicians are often the first line of healthcare and can resolve potential health problems before they reach the stage of needing a specialist. That kind of preventive care means lower healthcare costs. More primary care physicians can also lead to better outcomes and patient satisfaction.
There are more physicians in the U.S. than a decade ago. The biennial census from the Federation of State Medical Boards found there was a 12% increase in the number of actively licensed physicians from 2010 to the end of 2016. The U.S. physician-to-population ratio increased from 277 physicians per 100,000 people to 295 per 100,000.
The issue though is that many new doctors are going into specialties. One reason is the better compensation models for specialties. The Medicare Payment Advisory Commission reported in March that primary care physician compensation is much lower than specialists, which raises “concern about fee schedule mispricing and its impact on primary care.”
The healthcare industry has tried to lure more physicians into primary care through low-interest student loans, but it hasn't been enough to tempt more young doctors into primary care. As policy leaders look for ways to contain healthcare costs, the next avenue could be changing payment models to increase primary care physician compensation.