New Data from AAFP Reveals Increased Complexity of Family Physician Visits

Monday, March 7, 2016

Janelle Davis
American Academy of Family Physicians
(800) 274-2237, Ext. 6252

LEAWOOD, Kan. -- Patients are seeking more health care services, and patient encounters are becoming more complex, according to a recent snapshot survey of AAFP member physicians.

  • Seven in 10 respondents have experienced an increase in the number of health issues addressed in a    single office visit.
  • More than half (54 percent) said more patients sought treatment for conditions they had previously ignored.
  • Sixty-two percent noted an increase in patients seeking an annual check-up.
  • More than four in 10 (43 percent) said they witnessed an increase in patients with severe health complications.

The snapshot provides an on-the-ground view of research. It echoes similar findings from a recent study, "Complexity of ambulatory care visits of patients with diabetes as reflected by diagnoses per visit,"(379 KB PDF) by the Robert Graham Center. The study, published in the February 2016 issue of Primary Care Diabetes, reported, "Almost 80 percent of visits made by adults with diabetes to subspecialists involved care for that single diagnosis; while 55 percent of visits to primary care involved care for at least one additional diagnosis. Almost 70 percent of visits in which only one diagnosis was reported were to subspecialist physicians. Almost 90 percent of visits in which four diagnoses were reported were to primary care physicians."

Also, according to 2006-2008 National Ambulatory Medical Care Survey data analyzed by the Altarum Institute, family physicians often treat a larger percentage of complex conditions than many sub-specialists--most notably circulatory, endocrine and respiratory disorders.

Altogether, the findings have implications for payment policies as the U.S. health care system moves away from paying for volume and toward paying for the value of services, according to Robert Graham Center researcher Miranda Moore, PhD. The complexity of care within a single office visit will need to be recognized and more accurately compensated, she said.

“As we move forward with changing the way we pay for care, we need to look at the breadth of what’s being addressed within each office visit to measure complexity,” Moore said. “We need to consider various measures of the complexity of care physicians provide in a single visit.”

Wanda Filer, MD, MBA, president of the American Academy of Family Physicians, agreed.

"Family physicians bring tremendous value to the health care system, yet current payment models fail to account for the complexity of the care they deliver," she said. "As population health management becomes more challenging and the country moves forward with health care payment reform, value and outcomes should be rewarded along with accommodations made for the cognitive work required to treat complex chronic health conditions."

Editor's Note: Click here to view the online media kit.


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Founded in 1947, the American Academy of Family Physicians represents 134,600 physicians and medical students nationwide, and it is the only medical society devoted solely to primary care.

Family physicians conduct approximately one in five of the total medical office visits in the United States per year – more than any other specialty. Family physicians provide comprehensive, evidence-based, and cost-effective care dedicated to improving the health of patients, families and communities. Family medicine’s cornerstone is an ongoing and personal patient-physician relationship where the family physician serves as the hub of each patient’s integrated care team. More Americans depend on family physicians than on any other medical specialty.

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