Most seniors switch doctors only if forced

November 17, 2004

WASHINGTON -- Nearly nine out of ten seniors switch their primary care physicians because they are forced to - not by choice. That's the finding of research published in the November edition of The Journal of the American Board of Family Practice.

Analyzing survey data from nearly 800 patients 65 and older, researchers found that 14 percent of seniors changed physicians in a single year. Of those, almost nine out of 10 changed their physicians involuntarily. Insurance-related reasons accounted for 44 percent of the switches. Forty percent of the patients sought new physicians because their former doctors had moved, retired, or died.

"This study should raise concerns about changes in the health care system in recent years, including insurance and physician workforce instability," said James W. Mold, M.D., M.P.H., lead author. "Maintaining a long-term relationship with a primary care physician - what we call 'continuity of care' - is associated with better health outcomes for patients at a lower cost. It also increases the likelihood patients will take their medications as directed and keep their medical appointments."

Mold is director of the Research Division in the Department of Family and Preventive Medicine at the College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, and adjunct professor for the Department of Geriatric Medicine. Joining in the research was Ed Fryer, Ph.D., then with The Robert Graham Center: Policy Studies in Family Medicine and Primary Care in Washington, D.C.

"Current proposals for reform and expansion of the Medicare program, particularly those that promote privatization, could potentially increase the rate of involuntary discontinuity because of insurance coverage changes and further instability in the physician workforce," the researchers concluded. "This would probably have a significant negative impact on the quality of primary health care services available to the elderly."
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Note to journalists: To interview Dr. Mold, please contact Maureen Maxwell at 202-232-9033, 800-274-2237, or mmaxwell@aafp.org.

The Journal of the American Board of Family Practice publishes original papers pertaining to clinical investigations and case reports and review articles pertinent to the specialty of family medicine. The full text of "When Do Older Patients Change Primary Care Physicians?" can be accessed at http://www.jabfp.org/.

The Robert Graham Center conducts research and analysis that brings a family medicine perspective to health policy deliberations in Washington. Founded in 1999, the Center is an independent research unit working under the personnel and financial policies of the American Academy of Family Physicians. For more information, please visit www.graham-center.org.

The information and opinions contained in research from the Robert Graham Center do not necessarily reflect the views or policy of the AAFP.

American Academy of Family Physicians

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