Primary Healthcare in AmericaMeghan Bohren

Primary care physicians consist of:◦ Family physicians/general practioners◦ General internists◦ General pediatricians◦ Geriatricians

In 2010, there were approximately 209,000 practicing primary care physicians for a population of 312,648,000◦ 1 primary care physician per 1496 people

624,434 physicians who spend the majority of time in direct patient care◦ Less than 1/3 are specialists in primary care

Primary Care Physicians

Statistics from the Agency for Healthcare Research and Quality http://www.ahrq.gov/research/pcwork1.pdf

In 2010, Americans made 956 million visits to office-based physicians

Primary Care Visits

Statistics from the Agency for Healthcare Research and Quality http://www.ahrq.gov/research/pcwork1.pdf

Other health professions developed in the 1960s to address the physician shortages

Nurse practitioners: registered nurses who complete a higher degree (Masters or PhD) and are certified through state-level accreditation◦ Focus on the patient’s condition and the effects of illness on the family◦ Prevention, wellness, patient education◦ Scope of practice depends on the state – may work independently or

collaboratively with a physician◦ 56,000 NP in 2010

Physician assistants: receive training in the medical field, not nursing, and are trained to assist physicians◦ Conduct physical exams, diagnose illnesses, write prescriptions◦ 30,000 PA in 2010

Other Primary Care Professionals

Statistics from the Agency for Healthcare Research and Quality http://www.ahrq.gov/research/pcwork1.pdf

Mixed market health system◦ Government sources (federal, state, local) account for 45% of

health expenditures◦ Private sources account for 55% of health expenditures

38% of Americans receive health coverage from their employers

17% of Americans receive health coverage from private payment such as private insurance and out-of-pocket copays

12-16% of Americans do not have any health insurance

Structure of the Health System

The United States is the only developed nation without a universal health care system

Current debates in Congress to provide affordable primary healthcare to all Americans under the 2010 Patient Protection and Affordable Care Act

Medicare – provides insurance for the elderly and disabled with a work history

Medicaid – provides insurance for some low-income families

Health Care Reform

Questions?