Patient visits to family physicians becoming more complex

Family physicians are reporting increased complexity of patient visits, according to a recently released survey by the American Academy of Family Physicians.

The AAFP snapshot includes results from a survey of 209 AAFP members, collected from November 2014 through October 2015. The findings suggest that 70% of respondents have experienced an increase in the number of health issues they address in a single office visit. In addition, 43% reported an increase in the number of patients with severe health complications.

An AAFP press release announcing the survey stated its findings have implications for payment policies, as the “complexity of care within a single office visit will need to be recognized and more accurately compensated.”

“Family physicians bring tremendous value to the health care system, yet current payment method models fail to account for the complexity of the care they deliver,” Wanda Filer, MD, MBA, president of the AAFP, said in the press release. “As population health management becomes more challenging and the country moves forward with health care payment reform, value and outcomes should be rewarded along with accommodations made for the cognitive work required to treat complex chronic health conditions.”

Other survey findings released include 54% of member physicians reporting that more patients have sought treatment for conditions they had previously ignored, and 62% indicating they had witnessed an increase in patients seeking an annual checkup.

According to the AAFP, the survey’s results align with a study published in the February 2016 issue of Primary Care Diabetes, “Complexity of ambulatory care visits of patients with diabetes as reflected by diagnosis per visit,” from research conducted by the Robert Graham Center, which found that nearly 55% of adult visits to primary care physicians for diabetes involved services at least one other diagnosis. In contrast, “80% of visits made by adults with diabetes to subspecialists involved care for that single diagnosis,” the researchers wrote.

In addition, the study found that 90% of physician visits in which four diagnoses were reported were made in primary care offices.

The AAFP also noted data from the 2006-2008 National Ambulatory Care Survey, analyzed by the Altarum Institute, which indicate that family physicians often treat a larger percentage of complex conditions for patients aged 45 to 64 than many subspecialists, including circulatory (35%), endocrine (40%) and respiratory (44%) disorders. – by Jason Laday

Additional reading:

http://www.aafp.org/media-center/kits/complexity-of-care-of-family-physician-visit.html