Hepatitis C Treatment by Early-Career US Family Physicians

Despite highly effective therapies for the hepatitis C virus (HCV), treatment rates remain low. Management of HCV is shifting to primary care, and family physicians are positioned to provide this care. Our objective was to determine the extent of early-career family physicians' provision of HCV treatment.

We merged 2016-2023 data from the American Board of Family Medicine National Graduate Survey, which is administered 3 years after completing residency, with state-level HCV mortality data from the Centers for Disease Control and Prevention (2017-2021). We conducted bivariate analyses to examine differences in HCV treatment by physician characteristics, practice type, and practice location. We created maps to visually explore HCV treatment and mortality by state.

Overall, less than 20% of early-career family physicians reported treating HCV patients. Early-career family physicians HCV treatment rates exceeded 25% in 2016 and 2017, with rates falling to below 15% from 2018 to 2020, before rebounding to 23% in 2023. Early-career family physicians who were males, had MDs (compared to DOs), were international medical graduates, and were in nonmetropolitan areas and in medically underserved area practice types had significantly higher HCV treatment rates. State-level variation was observed, with higher early-career HCV treatment rates in states with higher HCV mortality.

While HCV treatment has been simplified over the past decade, HCV treatment by early-career family physicians has declined. Despite this decline, early-career family physicians have higher rates of HCV treatment in higher-need areas and in medically underserved practice settings. Supporting family physicians through education, clinical exposure, and incentives may increase provision of HCV care to address unmet needs.