Why having a primary care doctor makes a big difference
A new study from Northwestern Medicine, published January 28th in JAMA Internal Medicine, has uncovered a massive difference in healthcare quality between patients who have a primary care doctor and those who don’t. This is the first study to examine the quality of outpatient care between adults with and without a primary care physician.
Those with a primary care doctor often received higher-value healthcare such as getting recommendations for flu shots and cancer screenings. They also reported a better healthcare experience and better access to necessary healthcare options.
In the study, patients who stated they had primary care had a single doctor or physician outside of the emergency department “to whom they “usually go if [they] are sick or need advice about [their] health.” These patients could also answer “yes” to the “four C’s” regarding their primary care:
- First Contact (new health problems)
- Comprehensive (preventive health care, like general checkups, examinations and immunizations)
- Continuous: (ongoing health problems)
- Coordinated (referrals to other health professionals if and when needed)
“People who have primary care are fundamentally different from those who do not; they tend to be older, better insured, more white, etc.,” said senior study author Dr. Jeffrey Linder, chief of general internal medicine and geriatrics in Northwestern University’s Department of Medicine. “Our advance was to look at healthcare for Americans who were otherwise as similar as possible — but did or did not have primary care.”
To do so, researchers analyzed data from a nationally representative survey of the U.S. population and compared the patients with primary care to Americans with a similar demographic and health status, yet without a primary care doctor. Researchers then established a control for potential surprise factors, including socioeconomic status, physical health and mental health to make comparison between the two groups as unbiased and equivalent as possible.
The results showed that even though the two groups may have received similar care, those with a primary care doctor have higher-quality healthcare and better access to screening, preventative services, and testing. However, those with primary care are also slightly more likely to receive low-care in specific areas like prescriptions (being prescribed unnecessary antibiotics).
“We have further work to do to optimize the amount of high-value care and minimize the amount of low-value care we are delivering to patients,” Linder said.
However, overall, primary care has been proven to be effective and beneficial to the public. Therefore, the researchers argue that policymakers should invest in primary care to increase the overall value of the country.