90th annual Physician Report: Top nine issues facing primary care

April 29, 2019

A slideshow of the biggest challenges facing primary care in 2018.

Primary care physicians continue to face many of the same issues they did last year. Paperwork, faulty EHRs, and increased competition all made this year’s list.

With the increasing availability of online medical information, more patients are turning to Dr. Google before going to see their physicians. While this can lead to higher patient engagement, it also can result in patient misinformation, erroneous self-diagnoses, and conflict between patients and physicians over treatment plans.

More than one in three physicians are sued for malpractice at some point during their careers, according to AMA’s Division of Economic and Health Policy Research. General surgeons and OB/GYNs are the most likely to be sued followed by emergency physicians, internists (32 percent), family doctors (33 percent), and pediatricians.

Convenient alternatives to the doctor’s office are on the rise. According to Consumer Reports, there are currently over 1,100 CVS MinuteClinics and more than 8,000 urgent care centers in the U.S., with 500 to 600 more expected to open this year.

The United States is facing a serious shortage of doctors. A 2018 report by the Association of American Medical Colleges predicts a shortfall of between 14,800 and 49,300 of primary care physicians by 2030.

Learn more about recruiting and retaining young physicians here.

A 2018 MGMA report found primary care pay rose more than 10 percent over the past five years, nearly double the rate of specialist pay during the same time period. But even with these gains, primary care docs earned a median income of $257,726 in 2017-while specialists earned a median of $425,136.

The 2018 Medical Economics EHR Report found that 70 percent of physicians would like to switch systems but don’t because of high costs and lack of better options. In addition, about 57 percent would not recommend their current system to a fellow physician.

Read more: Difficulty using EHRs

Primary care physicians are increasingly plagued by outside interference that hinders their ability to care for patients. Many physicians name prior authorizations as the most common interference, but other sources include the government, hospitals, EHR vendors, and physician advocacy groups.

Trends such as value-based care and payer consolidation have made negotiating contracts with payers much more difficult in recent years.

Consistent with last year, paperwork/quality metrics tops the list with 72 percent of respondents naming it as the biggest challenge facing primary care.

Learn more about reducing the paperwork burden here and here.