New Study Shows Critical Role for Primary Care Specialists

Most Often the Source of Preventive Care

Americans made an estimated 890 million doctor visits in 2002, and a majority of those visits were to primary care specialists, according to the latest annual report from CDC’s National Ambulatory Medical Care Survey, which looks at the medical care provided in physicians’ offices.

Primary care specialists (such as general practitioners, family physicians, internists, pediatricians, obstetricians and gynecologists) play important roles in the health care system: serving as personal care physicians, providing preventive and diagnostic services, counseling and educating patients on appropriate health behaviors, managing and coordinating patient care, and facilitating access to specialty and follow up care. During 2002, six out of every 10 doctor visits (an estimated 560 million visits) were to primary care specialists.

The survey, which collects information on visits to non-federally employed physicians providing office-based care, included a supplemental sample of primary care specialist physicians in 2002 to spotlight the role of this group and provide comparisons between primary care and other specialists. In 2002, about 20 percent of all doctor visits were to surgical specialists (such as orthopedic surgeons and urologists) and 17 percent were to medical specialists (such as allergists and dermatologists). While these medical and surgical specialists can (and do) provide primary care and preventive services, nine out of 10 preventive care visits are to primary care specialists. Preventive care includes services such as general medical exams, prenatal exams or pap tests. Primary care specialists are also more likely to conduct diagnostic and screening services than surgical or medical specialists.

About a fifth of primary care specialists made one or more home visits during a typical week of practice (compared to about 6 percent of medical and surgical specialists) and during a typical week they averaged about 12 visits. Primary care specialists also reported more telephone contacts with patients.

In addition to its 2002 spotlight on primary care, the new report profiles visits to all office-based doctors. In looking at visits to all doctors, the most frequent patient diagnoses in 2002 were:

Hypertension (high blood pressure)

Common cold

Sore throat

Diabetes

Arthritis and joint disorders.

At about two-thirds of doctor visits, patients were ordered, prescribed or administered one or more medications, totaling 1.3 billion drugs in 2002.

The utilization of drugs has increased by 25 percent over the past decade, driven primarily by an increase in those receiving multiple drugs. The most frequent drugs prescribed during doctor visits in 2002 were in three classes: NSAIDS (non-steroidal anti-inflammatory drugs such as ibuprofen and similar drugs), antidepressants, and antihistamines. From 1995 to 2002, NSAIDS use increased by 10 percent, antihistamine use by 35 percent, and antidepressants were up by 48 percent. The use of antidepressant drugs in children increased by 124 percent from 1995 to 2002.

The survey found other changes in medical care in the past 10 years. From 1992 to 2002, the percent of visits by patients with private insurance increased by 80 percent and the percent of visits where there was no third-party payer declined by 77 percent. During the same period, the visit rate for persons 45 years of age and over increased by 14 percent. In 2002, about 75 percent of physicians used electronic billing records, but only about 17 percent have electronic medical records.

The report, "National Ambulatory Medical Care Survey: 2002 Survey," and more information about the survey conducted by CDC’s National Center for Health Statistics can be found at http://www.cdc.gov/nchs/. The survey is part of the National Health Care Survey, which also covers hospitals, outpatient and emergency departments, ambulatory surgery centers, nursing homes, hospices, and home health care. The survey provides an opportunity to examine health care across a range of settings and to monitor patterns and shifts in the way health care services are provided and used.