Shortage of primary care doctors could bring crowded ERs: Study

Americans living in areas where primary care doctors and nurse practitioners are in short supply face a greater risk for emergency surgeries and complications, new research shows.

They’re also more likely to wind up back in the hospital after they’ve left it.

That’s because serious health issues don’t get addressed until they become emergencies, said lead study author Dr. Sara Schaefer, a resident in the University of Michigan’s Department of Surgery.

“The role of the primary care provider in identifying a potential issue, and referring a patient for diagnostic imaging and surgery, can make a major difference in addressing an urgent problem before it becomes an emergency,” she explained in a university news release.

For the new study, her team looked at data for Medicare patients in areas where the federal government has identified a shortage of primary care providers.

Patients had operations for three conditions where timing is critical: colectomy to remove a cancer from the colon; hernia repair; and repair of aneurysms in the the body’s largest blood vessel, the aorta.

Nearly 38% of those in areas with more severe shortages required emergency surgery, compared with 30% of those in areas with the least severe shortages, the study found.

They also had a higher risk for serious complications (15% versus about 12%), and hospital readmission (nearly 16% vs. 13.5%).

The study found no difference in patients’ risk of death based on provider shortage rates, but researchers did find that the risk of premature death was higher for those living in areas with shortages.

Nearly 6 in 10 census tracts classified as having a shortage of primary care providers were in rural areas.

The findings were published in the March issue of the journal Health Affairs.

Schaefer said the study holds an important message for people living in shortage areas: Find a primary care provider for regular care, even if getting an appointment takes awhile. It’s also important to pay attention to new symptoms, she added, and to know how escalate a concern with your regular provider.

She said surgeons need to realize that some patients are undergoing urgent or emergency operations because they lack regular primary care.

Schaefer called on surgeons to work with their patients while they’re in the hospital to make sure they have a primary care provider going forward.

“The role of the primary care doctor as a partner in care of our surgical patients cannot be overstated,” she said.

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