The Future of Primary Care is Virtual
Virtual Primary Care is the Future, and the Future has Arrived
The number of primary care clinicians—including physicians, nurse practitioners (NPs), and physician assistants (PAs)—has continuously declined for over a decade. The Affordable Care Act has hastened that decline demise. The reasons are many:
In an effort to make primary care affordable to all, the ACA dumbed it down to little more than a review of lab work and a patient interview. The result is more referrals to specialists, driving costs up, not down.
Primary care physicians generally earn significantly less than most specialists (in particular, those who do procedures). While medical school costs the same for all.
A high percentage (45%) of primary care physicians report burnout, and 39% of those plan to stop seeing patients.
A high percentage of primary care physicians are nearing retirement age with their younger replacements lagging in numbers.
The problem is reaching crisis levels in rural areas.
Over 66% of designated primary care Health Professional Shortage Areas (HPSAs) are in rural regions
Rural clinics and hospitals are closing at an alarming rate, leading to longer travel distances. This is particularly hard on the elderly and working Americans, leading to fewer seeking regular care.
More than 30% of U.S. adults lacked a reliable source of care in 2022—the highest level in a decade. The result is both financially and medically disastrous.
Patients without access to primary care often turn to emergency departments, driving up healthcare costs for everyone and
Chronic conditions go unmanaged, worsening health outcomes and increasing long-term costs
The Solution is Virtual Care
The virtual environment offers hope for the future.
Various studies suggest that between 40% and 90% of primary care can be delivered virtually, including chronic disease management, mental health support, medication refills, and preventive screenings.
Virtual care is more seamlessly integrated between preventative care, acute care, mental health and the support services patients need.
Virtual care is portable when moving from place-to-place, and it is accessible everywhere there’s a connection to the internet.
Virtual care relieves provider burnout because it makes better use of technology to augment providers.
The Future Has Arrived
Virtual approaches to primary care, complemented with devices such as Bluetooth blood pressure monitoring, live-streaming stethoscopes, spirometers, and simple EKGs are just some of the devices already available. Technology is coming fast.
The future of virtual care has already arrived; now it’s time for the system to catch up with it.
Specialists Can Provide the In-Person Care People Need
Invariably, there are things people need to be seen for in-person. Specialists can take care of those things, because that’s already what’s happening.
Because of the ACA’s limits on primary care, the ratio of specialist visits to primary care visits has inverted over the past decade. Ten years ago, there were 2 visits to a primary care provider for every one visit to a specialist. Today, it’s the inverse: 2 visits to a specialist for every visit to a PCP. That is the result of hospital systems acquiring PCP practices to drive more referrals to their specialists, and PCPs not getting paid enough to take the time to dig deeper into people’s problems before referring them. So, the change has already begun, it’s just not been acknowledged yet.
The independence afforded by virtual primary care providers reduces the number of unnecessary specialist referrals because they are not part of the same system. This, in turn, reduces the burden on specialists freeing them up to see those who really need them sooner.
The shift to all virtual primary care may lead to a few more referrals to specialists for those things that really require an in-person exam, but net-net, that means the whole system becomes more affordable, more accessible, and more effective for everyone.
We have to look at solutions through the lens of the entire system, not in discrete elements. Virtual care at the center of the system will make it better for everyone.