The American Academy of Family Physicians has made these charts and graphs available for use by journalists to help illustrate the care delivered by family physicians. For additional information, please contact us.
Medical care is complex. More people are coping with multiple, complex health conditions. Advances in medical technology and treatment options are growing exponentially. That’s why family physicians are the foundation of high-quality care. Family physicians’ extensive education and expertise in treating the whole person, managing highly complicated conditions and ensuring comprehensive preventive care are the foundation of good patient care.
Medical student interest in family medicine continued its growth in 2014 for the fifth consecutive year. Known as the Match, the National Residency Matching Program aligns graduating medical students with residency training programs in specialties they want to pursue. The current trend indicates students’ awareness of family physicians’ importance in patient care and a greater appreciation for the role they will play in a reformed health care system. The value of primary care has become much more apparent because health care reform has focused a bright light on continuous, comprehensive care as found in the patient-centered medical home.
More than 70 percent of graduating family physicians complete their education with more than $50,000 in educational debt. Nearly four in 10 graduating family physicians must repay school loans for $200,000 or more.
Virtually every medical student takes on debt, regardless of the specialty they choose as a career. Medical student debt influences the career choices of medical school graduates. As their debt soars, medical students are more likely to go into subspecialties that pay more than primary care careers. The U.S. health care system pays more for procedures to intervene in a disease process than for primary care physician-patient interaction that could prevent the disease. As a result, subspecialists who provide more procedures than family physicians and other primary care physicians, earn far more.
Family physicians and their primary care colleagues rank lowest in income of all medical specialties. The U.S. health care system pays more for procedures that intervene in a disease process or injury than it pays for patient-physician office visits that prevent disease and injury. The result: an expensive health care system that strains the financial capacity of individuals, employers, and public safety net programs.
Health care policy analysts say that efficient, high quality health care systems are based on primary medical care. The United States does not currently have such a system; only 43 percent of physicians (family physicians, internists, obstetrician-gynecologists, pediatricians, and general practitioners) provide primary care services.
Americans’ dependence on primary care is reflected by the number of office visits they make to various specialties. Although primary care physicians constituted only 38 percent of all U.S. physicians, they provided more patient care visits compared with other medical specialist groups or care settings. In fact, annual visits per generalist physician were 30 percent higher than visits per specialty physician, from 2009 to 2010, according to the most recent data(www.cdc.gov). This graph shows that primary care practices had more patient visits than medical and surgical subspecialties combined.
As family physicians and their primary care colleagues transform their practices to patient-centered care, access to care has improved. For example, the average time to get an appointment with a primary care physician is less than 1 week, and more than 82 percent of primary care physicians provide same-day appointments.
The time spent providing patient care affects access to medical services. In addition to the time spent coordinating care with other professionals and community resources, reviewing charts, working with pharmacists and insurance companies, and other responsibilities outside the exam room, primary care physicians spend at least 75 percent of their office hours – more than 31 hours a week – providing direct care to patients. Four out of 10 primary care physicians offer evening and/or weekend office hours.
Family physicians provide a wide range of hospital-based services, including intensive and coronary care, emergency care, pediatric and newborn care, and minor surgery.
Most medical students are trained in university-based hospitals known as academic health centers, which care for the most seriously ill patients. This hospital-based education skews medical students’ perception of medical practice, because most patients get their care in doctors’ offices and community settings. In fact, very few of students’ future patients will actually require care in such a high-tech, tertiary care hospital as an academic health center.
Data show that for every 1,000 Americans:
A recent Harris Interactive Poll sponsored by the AAFP found that women who make health care decisions for themselves and their families want elements of a patient-centered medical home.
Among the most important elements are same-day appointments for unexpected illnesses and having a physician who knows all the family members’ medical histories, who coordinates care with other doctors and who cares for all family members.
Section 747 of Title VII of the Public Health Services Act is the most important program for encouraging primary care medical education in medical schools. This funding is to be used specifically to build on primary care medical education. Despite the growing shortage of primary care physicians, federal funding for Section 747 of Title VII has plummeted from $92.4 million in fiscal year 2003 to $48 million in 2008. This graph demonstrates the changes in funding levels based on the consumer price index for professional medical services, using 1984 as the baseline year for adjustment.
Every state in the Union will need significantly more family physicians by 2020, according to the 2006 AAFP Workforce Report. The report predicted a national need for 139,531 family physicians by 2020. The United States already has a shortage of family physicians, and demand continues to rise. Merritt Hawkins, a national physician recruitment company, reports that recruitment requests for family physicians grew by 62 percent between 2006-2007 and 2007-2008. Requests for family physicians grew by 196 percent between 2004-2005 and 2007-2008.
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