Measuring Primary Care Capacity: Unique Patients Seen per Year and Implications for Workforce Shortages

Area of Science:

• Healthcare workforce analysis
• Public health policy
• Physician demographics

Background:

• Growing primary care physician (PCP) shortage in the US.
• Increasing demands on PCPs' time and patient volume.
• Need to update PCP workforce shortage estimates in Virginia.

Purpose of the Study:

• To update primary care physician (PCP) workforce shortage estimates in Virginia.
• To assess the number of unique patients seen annually per PCP.
• To evaluate variations in patient loads by physician, practice, and community characteristics.

Main Methods:

• Analysis of Virginia's all-payer claims database (APCD) from 2016-2021.
• Inclusion of licensure, claims, census, and clinician survey data.
• Iterative bootstrap simulation to estimate PCP shortage considering panel size and Full-Time Equivalent (FTE).

Main Results:

• In 2021, Virginia had 4,508 PCPs, with 34.2% over age 60.
• Median unique patients seen per PCP was 1,290; average total visits were 2,800 annually.
• A 28.8% PCP shortfall was estimated for 2021, an increase from 17.7% in 2016.

Conclusions:

• Primary care workforce shortages are more severe than previously estimated.
• Patient volume and FTE significantly impact shortage calculations.
• Ideal PCP patient panel size requires consideration of clinical complexity and practice resources.