Fewer Family Physicians Seeing Children

Fewer family physicians are seeing children, according to a new study in the Annals of Family Medicine.

The study focused on the years 2006-2009 and was based on data from physicians who took the American Board of Family Medicine’s Maintenance and Certification Examination. Researchers found 74% of family physicians saw children in 2006, but by 2009 the proportion had dropped to 68%.

The study was authored by researchers from the Robert Graham Center, the Association of American Medical Colleges, the Dartmouth Institute for Health Policy, and the American Board of Family Medicine.

The majority of children see pediatricians for their primary care, but the study notes children see family physicians in about 16-21% of primary care visits.

The drop in family doctors seeing children also comes at a time when public health officials are warning of looming physician shortages.

“Child healthcare physician supply and capacity are likely to be further stretched by current health reform efforts that promise increased health insurance coverage for children and adults,” the authors note. “Family physicians, especially in rural and underserved areas, may face impossible demands to care for a larger insured population, resulting in decreased capacity to provide care for children.”

About 76% of rural family physicians saw children in 2009. That’s higher than average, but it’s lower than the 82% reported in 2006. Rural doctors who practice in areas with few pediatricians were more likely to see children.

The study also found that older doctors were less likely to see children, as were international medical graduates.

Family physicians in partnership practices were more likely to see children than their peers in group practices.

The authors put forth a number of considerations for policy makers. For instance, they suggest incentives may need to be created to support family physicians who want to maintain maternity care.

“Policy makers must consider how ongoing discussions of payment reforms, principally aimed at value-based purchasing and broader population management, influence access to care for children in areas with few providers,” the authors say.

The study says policy makers should also consider whether current family medicine residencies provide adequate pediatric training.

The complete study is available here.