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Solving Primary Care Physician Shortages

Richard Siegrist

You may have seen the recent article in Health Affairs regarding addressing the problem of primary care physician shortages.  Using simulation modeling, it makes a strong case that those shortages could be eliminated through the use of physician teams, non-physicians and electronic communication.

In order for it to work, patients need to be willing to see one of several different physicians for a given appointment (physician pooling) and/or a nurse practitioner/physician’s assistant for some appointments.  Other appointments could be avoided through electronic communication channels.  It also assumes an advanced access or moderate access appointment model and the operational changes needed in a medical practice under that model.

There is an alternative approach that would allow patients to continue to see their primary care physician on a consistent basis and eliminate physician shortages – shared medical appointments.  By seeing 10 to 12 patients in a 90 minute period for routine and chronic medical appointments, physicians can effectively double their productivity and patients can be seen on a timely basis, minimizing appointment wait times.

When you add the additional benefits of interacting with other patients and spending more time with their physician, patients may find shared medical appointments a more compelling approach.  And given shared medical appointment potential to reduce physician burnout, it may be a better choice for a medical practice overall.

The Health Affairs article estimates that the demand for primary care will increase by 50% over the next 20 years due to population growth, the aging of the population and insurance coverage expansion under the Affordable Care Act.  If shared medical appointments can be used for half of primary care visits (some believe they can be used for a much greater proportion), the doubling of physician productivity for those visits would approximately offset the 50% increase in demand.  More specifically, 50% of visits done via SMAs * 2 for productivity increase = 100% + 50% for remaining traditional visits = 150%.

You can try various scenarios in our calculator to show how regular shared medical appointments can go a long way to alleviating primary care physician shortages and related long appointment wait times.