A new study by WD Partners has confirmed what we all know about primary care access – it’s changing. Virtual care and urgent care are gaining in popularity as convenience becomes the primary driver of consumer preferences. No longer content to wait days or weeks for a doctors appointment, many patients are willing to receive care through urgent care clinics often staffed by nurse practitioners or physician assistants. Kaiser Family Foundation reported that 26% of patients in a recent poll don’t have primary care doctors. This is significantly worse for millennials who, 45% of the time, go without a designated doctor. But the report highlights that it’s not only millennials; there is a lack of primary care doctor alignment at all ages.
Those consumers should be mindful of a Journal of the American Medical Association (JAMA) article, which makes the point that this strategy may result in sub-optimal care. The JAMA study reports higher levels of screening for diabetes, cancer and counseling with primary care doctors. A further study concludes that almost 50% of patients seeking care from an urgent care or emergency room setting for a respiratory infection, cold or flu received antibiotics (both unnecessary and potentially harmful) as compared with 17% for care administered by a regular primary care doctor.
Just the other day, I heard a radio advertisement from Quest Diagnostics, the laboratory company, with a direct appeal to consumers for routine lab testing without the need to see a doctor first. I recall thinking that it was odd, but it must be in response to a reduction in primary care visits – and to testing which has become easier to interpret and is geared toward specific, potentially self-diagnosed medical concerns. And at Costco this past weekend an A1C screening booth was set up for diabetes detection.
This trend was no doubt the driver of the acquisition of Aetna by CVS. Armed with electronic medical records and frequent interactions with your pharmacist who is visited monthly, care can be convenient and also personalized. I believe care delivery is changing for the better. Like almost everything, it is going to take time.