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COVID-19 has taken a toll on the workforce across U.S. industries, from hospitality to manufacturing to retail—and healthcare is certainly no exception. Stress on the system, increased costs, labor shortages and escalated personal risk of illness created a perfect storm of higher burnout and lower resiliency among primary-care providers.
As patients’ most trusted source of health information, primary-care clinicians’ work should be highly valued. The field is too critical to collapse. Unfortunately, it might do just that.
The crisis we face today
In March 2020, the Larry A. Green Center at Virginia Commonwealth University launched a national survey series tracking the effect of COVID-19 on primary care. Two years into the pandemic, our most recent survey—with a sample comprising 73% family physicians and 27% other specialties, such as internists, pediatricians, nurse practitioners and psychologists—showed the primary-care workforce is shrinking. In fact, 1 in 4 clinicians said they plan to leave the field within the next three years, and 62% know of a colleague who already left during the pandemic.
Clinicians are stretched beyond their limits, with more than a third (35%) reporting burnout levels at historic highs, and more than half (53%) saying their ability to bounce back from or to adjust to adversity has become limited. Almost half of respondents (46%) endorse the notion that primary care is “crumbling.”
Here’s the message for senior healthcare leaders: Act now to ease the burdens on primary care, or it will fail on your watch.
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Stretched to the brink
Primary-care practices are usually the first stop for patients. Whether for preventive screenings or acute issues such as respiratory infections, upwards of 500 million visits per year—more than half of total outpatient visits—occur in these settings. Despite this critical role, primary care received less than 3% of emergency federal financial support as loans and assistance programs rolled out early in the pandemic.
More resources would have been useful to meet pandemic challenges, such as lack of personal protective equipment, the inability to administer vaccines, greater health risks and a rapid switch to telehealth. According to a 2021 study, primary-care clinicians died from COVID-19 at a rate five times that of any other specialty, including emergency department and intensive-care clinicians.
Despite being short-staffed, many practices have had to expand services. They have increased patient panels, incorporated mental health services, assisted with food and housing insecurity, and assumed responsibility for monitoring COVID-19 patients at home. According to our data, 40% of practices reported a higher caseload because patients’ previous offices closed; 44% said they have open clinician positions; and 68% have nonclinical positions they cannot fill.
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