Most primary care physicians worked as hard in 2008 as they did the year before, but the number of patients they saw increased
only slightly—even decreased in the case of ob/gyns, according to results of Medical Economics' annual survey on productivity.
POSTPONING NEEDED CARE
Primary care doctors saw the same number of patients or fewer in 2008 vs. 2007 because many patients, feeling the economic
squeeze of "the great recession" of 2008, cut back on all expenditures, including doctor visits, says Owen Dahl, a practice
management consultant in the Woodlands, Texas.
Hours Worked per Week
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"We find fewer patients coming to the office due to financial problems, fear of leaving their job for a couple of hours, and
not wanting to know about or deal with illness," he says. "As a result, many patients who do come to the office are sicker,
requiring more care and services, which slows the visit."
That was the experience of Judy Lindsey, MD, an internist in Milwaukie, Oregon, just outside of Portland. In 2008, Lindsey
and her two nurse practitioners saw fewer patients than they saw in 2007, despite working 60 hours a week. "By mid-year, even
people who still had jobs could not afford copays or gas to drive to their visits," she says. "Copays and deductibles keep
going up, shutting people out of the primary care system until they are so ill they end up in the emergency room."
Kathryn Moghadas, a consultant with Associated Healthcare Advisors in Fern Park, Florida, has seen the same scenario play
out with her clients. "When I query my doctors, I am hearing that many patients who have steep copays or high deductibles
are using medical care only as a last resort," she says.
This is especially the case with ob/gyns, says Jeffrey Denning, a consultant with Practice Performance Group in La Jolla,
California. As the survey indicates, most primary care physicians continue to see approximately the same number of patients
per week, but ob/gyns suffered a 10 percent decline in patient visits despite putting in the longest workweeks.
Patient Visits per Week
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"A large proportion of ob/gyn visits are—or are seen as—optional and postponable, and if paying the fee or meeting a deductible
and copayment are a problem, the patients may wait to schedule a visit," says Denning. "The same goes for orthopedics, otolaryngology,
and ophthalmology."
Moreover, ob/gyns have unpredictable hours, with deliveries and complications for which they are not adequately reimbursed,
according to Moghadas. And they often must spend more time with individual patients. "Ob/gyns who do not offer other services
such as midwifery or medi-spas are feeling the crunch," she says.
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Posted 2009-10-26 12:53:20.0
