Solo Practitioners: Important Contributors to Primary Care
Solo Practitioners: Important Contributors to Primary Care
Peterson et al raise important issues about the decline in the proportion of solo practitioners in primary care and whether it will have a detrimental effect on access to care in rural areas. They use practice organization data provided by family physicians who took the American Board of Family Medicine's recertification examination in 1993, 1998, 2003, 2008, and 2013 to track the proportion of family physicians in solo practice. The reported percentage was 13.9% in 1993, stayed approximately 16% from 1998 to 2008, and then decreased significantly to 11.0% in 2013 (P < .01).
Their work raises important questions:
To help frame discussion of these questions, we used data from all primary care practices with physicians, NPs, or PAs in 6 US states: Connecticut, Idaho, Kansas, Tennessee, Utah, and Washington.
Abstract and Introduction
Introduction
Peterson et al raise important issues about the decline in the proportion of solo practitioners in primary care and whether it will have a detrimental effect on access to care in rural areas. They use practice organization data provided by family physicians who took the American Board of Family Medicine's recertification examination in 1993, 1998, 2003, 2008, and 2013 to track the proportion of family physicians in solo practice. The reported percentage was 13.9% in 1993, stayed approximately 16% from 1998 to 2008, and then decreased significantly to 11.0% in 2013 (P < .01).
Their work raises important questions:
Are solo practitioners endangered?
How does considering other clinicians (nurse practitioners [NPs] and physician assistants [PAs] who bill for seeing patients) change the prevalence of solo practitioners?
How do the patient and community characteristics of small primary care practices compare with those of larger practices?
Are solo and small practices having more difficulty responding to payment and delivery system reforms such as becoming medical homes and participating in the Medicare electronic health record meaningful use incentive program?
How do cost, quality, safety, access, and patient experience outcomes vary by practice size?
How would declines in solo practitioners affect access to primary care?
Should policies support solo and small practices?
To help frame discussion of these questions, we used data from all primary care practices with physicians, NPs, or PAs in 6 US states: Connecticut, Idaho, Kansas, Tennessee, Utah, and Washington.
Source...