Primary Care & COVID-19: Round 29 Survey

It has been more than three months since the previous survey of primary care clinicians. The COVID landscape has shifted significantly since April 2021, with fluctuations in the number of COVID cases and progress on the vaccination front. Primary care practices and clinicians are now more involved in vaccinations but continue to report major concerns about the stability of the sector.

• Primary care is facing existential threats: Many parts of the country are seeing COVID cases surge again from the spread of the delta variant, causing primary care and other parts of the healthcare system to ramp up their response. Yet a sizable minority of primary care clinicians has grim doubts about their future. 40% of respondents say they worry that primary care will be gone in 5 years, and 21% say they expect to leave primary care within 3 years.
• Many clinicians see a role for the federal government in changing policy in primary care: Their top three requests of the government are to:
  1. Protect primary care as a "common good" - available to anyone regardless of ability to pay (56%)
  2. Change how primary care is financed so that it is not in direct competition with specialty care (46%)
  3. Change how primary care is paid, moving away from majority fee-for-service models (46%)
• Practices saw an easing of stress but are still struggling: A large majority of respondents – 76% – rank the strain on their practice from COVID-19-related changes and pressures in the month previous to the survey on the low or moderate end of the scale (1, 2 or 3 on a 5-point scale). However, more than 1 in 3 (36%) say they are constantly lethargic and find it hard to find joy in anything or struggle to maintain clear thinking at times.
• Practices are engaged in the vaccination effort: More than half (52%) of practices have received enough or more than enough vaccines for their patients, and 31% are partnering with local organizations or government to prioritize people for vaccination. However, more than half – 53% – note that vaccine hesitancy among unvaccinated patients is high and hard to counter.

Voices from the Front Lines

“[Our system] cut pay, closed clinics, laid off staff. 1/3 of our providers quit and we have literally 4000 patients to reassign and nowhere to put them.” – Clinician in Washington

Experiencing vaccine hesitancy

“Vaccine hesitancy requires at least 5-10 minutes of counseling for a less than 30% success rate.” –Clinician in Illinois

“Dealing with patients who don't want to get vaccinated is leading to burnout.” – Clinician in Nevada

Concerns for the coming months

“The work of primary care is time-consuming and that time is so poorly reimbursed.” – Clinician in Missouri

“High rates of depression without resources in the community.” – Clinician in New Jersey

Need a break

“I’m tired.” – Clinicians in Colorado, Pennsylvania, Washington, California, Texas, Illinois and Oregon