Primary Care Largely Open but Struggling

WASHINGTON, September 1, 2020 – The Larry A. Green Center, in collaboration with the Primary Care Collaborative (PCC), today released new data that shows that primary care is shrinking at precisely the time it is needed to help the country get back on its feet. In just the past month, 2% of practices have closed, another 2% are considering bankruptcy, and 10% are uncertain of their solvency for the coming month. Previous federal and commercial efforts have provided time-limited, modest support that is not enough to help sustain primary care practices and enable them to meet myriad COVID-19 challenges. One in 5 clinicians is now considering leaving primary care, and 13% are uncertain of their future in the profession.

Data from the survey of clinicians also reveals worsening patient health and social conditions. The most commonly observed conditions are: higher levels of mental health concerns (86%); more sleep issues (77%); and weight gain (73%). In addition, 34% of clinicians have seen higher levels of food insecurity among patients, 38% have seen higher levels of housing insecurity, and 58% report an increase in patients struggling to pay bills. 

“Primary care, as we know it now, was born during the civil unrest of the 1960s. Social justice is woven into its fabric,” said Rebecca Etz, PhD, co-director of The Larry A. Green Center. “Clinicians’ workloads have increased, environmental threats have increased, and they are trying to address social issues that contribute to health inequities. And still, we watch them fall. When will policy makers acknowledge primary care is too critical to collapse?”

“Patients – many who have delayed care and are in economic jeopardy with federal unemployment  support sunsetting  –  are presenting with a broader array of needs,” said Ann Greiner, President and CEO of PCC. “Primary care is responding by strengthening partnerships with public and behavioral health yet experiencing historic drops in revenue. We say to public and private policy makers: Primary care needs an immediate lifeline!”

The survey was conducted by the Larry A. Green Center, a research group in Richmond, Virginia. The survey is part of a regular Green Center series, sponsored by foundations, to look at the attitudes of primary care clinicians and patients during the COVID-19 pandemic and the abilities of practices to meet patients’ needs.

The survey of clinicians was fielded August 21-24, 2020, and received 636 responses from 47 states. 74% of respondents identify their practice as family medicine, 11% as internal medicine, 6% as pediatrics, 4% as geriatrics, and 3% as other. Settings include 24% rural, 11% community health centers, 10% in schools/offices, and 31% in designated patient-centered primary care homes. 29% have 1-3 clinicians in the practice, 30% have 4-9 clinicians, 41% have more than 10 clinicians. 43% are owned by a health system, 30% are self-owned, 12% are independent and large-group, and 3% are government-owned. 10% are convenience settings, and 4% are membership-based.

• more details on the survey findings
• executive summary of the survey

• Ann Greiner, president and CEO of the Primary Care Collaborative
• Rebecca Etz, PhD, co-director of The Larry A. Green Center