AAFP Survey Documents Recession's Impact on Access to Health Care

I'll call her Mary. She's a patient at our residency clinic who has diabetes, but she doesn't have health insurance. She recently came in complaining of dizziness, nausea and abdominal pain. When we checked her blood sugar level, we found it was sky-high -- well over 500. She said that's what she had suspected, but she couldn't be sure because she just couldn't afford to buy test strips anymore to check her blood sugar.

With some intensive work, we were able to help her avoid a hospitalization. We also gave her some test strips so she could get back to tracking her sugar levels, at least for a while.

I'm telling you about Mary because she is a veritable canary in the coal mine of the current recession. The recession is making her sicker, and, ultimately, it's making her care more expensive. The sobering truth is that stories like Mary's are playing out in family medicine practices all over the nation, according to a survey of family physicians just released by the AAFP. The results of the online survey confirm the negative and potentially serious impact the recession is having on Americans' access to health care.

Survey responses came from 505 AAFP members from across the country and represented a random sample of 8,297 members who were invited to participate, for a 6.1 percent response rate.

The family physicians' responses paint a grim picture of the recession's impact.

The recession also has hit many of the practices that care for these patients. More than half of survey respondents reported seeing fewer patients since the recession began. Nearly 45 percent said financial stress was forcing them to cut or consider cutting services for their patients, or to reduce staff.

Yet in spite of the financial consequences, these FPs have stepped up and helped their patients during this difficult time. Seventy-one percent of survey respondents said they had provided more uncompensated care during the past few months. Sixty-six percent reported taking specific actions -- such as cutting their fees, moving patients to generic prescriptions, or providing free screenings -- to help patients in this economic downturn. These actions are truly inspirational, and I applaud all of our members who have helped their patients get through these tough times.

The AAFP's new survey results sound a clarion call for health care reform, and their release couldn't have come at a better time. This month, for example, House Speaker Nancy Pelosi stated that the House would have a health reform bill on the floor by the end of July. New HHS Secretary Kathleen Sebelius urged Congress to enact reform that provides a medical home for every American, while shifting the nation's treatment paradigm from a sickness-based to a wellness-based system. There's never been a time when reform seemed more possible!

Rest assured that the Academy will use these new survey results to reinforce its call for health system reform that's based on the bedrock of primary care and the patient-centered medical home -- and to push for increased numbers of family physicians to make the reformed system work.

After all, that's exactly what Mary, and every patient like her, needs and deserves.