Number of primary care doctors in First State trending down

DOVER — The number of primary care physicians in Delaware declined about 6 percent from 2013 to 2018, according to a new study from the University of Delaware.

Even those who already have a primary care doctor in Delaware might face difficulty finding a new one in the future, with about 16 percent of doctors in the field age 65 or older.

The study, commissioned and released by the Department of Health and Social Services, found there were 815 individual primary care physicians practicing in Delaware in 2018. That’s a decrease of 47 from five years prior.

Once the number of hours they worked is taken into consideration, there were effectively 662 full-time physicians, the study found. There were 707 full-time or full-time equivalent Delaware doctors in 2013.

Primary care physicians practice in one of five specific fields: family practice, general practice, internal medicine, pediatrics or obstetrics/gynecology.

“In general, there are a sufficient number of primary care physicians in Delaware (1,475:1), although their location and specialty is probably not optimal,” the report notes.

In both Sussex and Kent counties, the ratio of patients to doctors is greater than 2,000:1, which the U.S. Health Resources and Services Administration uses to identify shortage areas.

Those negative trends could continue, especially in Kent: 21 percent of primary care physicians reported they will no longer be practicing in five years. Nineteen percent said they are not sure if they will be.

Statewide, about 70 percent of primary care physicians expected to still be in the field in five years.

The explanation for the spike in Delaware’s middle county appears to be simple: Almost 28 percent of primary care doctors in Kent were 65 or older, compared to 29 percent in New Castle and Sussex combined.

The reason behind that discrepancy is harder to identify.

“The best preventive care and the most cost-effective care is provided by a strong and coordinated primary care workforce,” DHSS Secretary Kara Odom Walker said in a statement. “Primary care providers know their patients and their medical histories best and can provide the most effective, high-value, longitudinal care for chronic health conditions and other preventable disease.

“As state government officials, our priority is to find ways to incentivize front-line care to perform as coordinated teams that are ultimately accountable for population health. We also need more primary care physicians to remain in practice and find ways to encourage new doctors, including those from minority and rural backgrounds, to choose primary care as their specialty.”

About 82 percent of physicians were accepting new patients in 2018, compared with 86 percent in 2013. Seventy-two percent said they took new patients on Medicare in 2018, while 78 percent said they accepted new Medicaid recipients.

The average wait time for new patients was 23 days in 2018, compared with 32 days in 2013. For established patients, it was six days in 2018, down from 17 in 2013.

The report also found large racial disparities: Although approximately 23 percent of Delawareans are black and 8 percent are Hispanic, just 11 percent of primary care physicians in Delaware fit into either category.

Doctors in Kent were less likely to have graduated from medical school in a neighboring state or to have completed their residency in Delaware than those who practice in New Castle.

In June, lawmakers passed a bill enacting several changes to the state’s primary care system. Those changes include mandating insurers reimburse providers at the Medicare rate, which is higher than many doctors would otherwise be compensated. The legislation also established a three-person panel that is expected to issue within the next week long-term recommendations aimed at strengthening the primary care model.

“It is vital that the State of Delaware, for the sake of Delawareans’ health, take steps to promote and strengthen primary care,” Sen. Bryan Townsend, a Newark Democrat who introduced the bill, said in a statement. “The declining rates of primary care providers practicing in Delaware or offering access to new patients are alarming.

“We have implemented immediate measures, and we have developed long-term solutions. The health and well-being of Delawareans, and the Delaware economy, cannot afford for us to delay in implementing those solutions, or for us to lack the courage to tackle complex policy and political issues.”

The study was conducted by mail in the spring and summer, with researchers contacting 2,533 physicians who had an active license and a Delaware address or an address with a ZIP code adjacent to the state. Of those, 957 doctors provided usable data, according to the findings.

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