When our family doctor said he would close his practice in April to work in urgent care, my wife and I were sad and a little anxious.

He knew our health issues and had provided our family with sound advice for 14 years.

It isn’t easy to find a new primary care doctor in Santa Fe. Some doctors are retiring and most are not accepting new patients.

The physician shortage isn’t limited to Santa Fe, however; it’s a national issue. According to the Association of American Medical Colleges, the U.S. could be short by up to 121,000 primary care and specialty physicians by 2030.

A recent national poll by the Kaiser Family Foundation found that 26 percent of Americans do not have a primary care physician. Over a third of millennials did not have a regular doctor, compared with 15 percent of those ages 50 to 64, according to the poll.

Many patients turn to urgent care clinics or the emergency room to address medical needs in lieu of visiting a primary care practitioner.

It’s not an ideal solution. Urgent care providers often have little information about a patient’s medical history and might not offer the best care.

A recent article in the Journal of the American Medical Association reported, for instance, that almost half of patients who sought treatment at an urgent care clinic for a cold, flu or a similar respiratory ailment left with an unnecessary prescription for antibiotics, compared with 17 percent of patients seen in a primary care office.

Economics might play a role in New Mexico’s shortage of primary care doctors.

The state had the lowest pay for primary care doctors in the U.S. in 2017, with doctors here averaging around $160,780 a year, according to a report by the U.S. Bureau of Labor Statistics. That compares with an average of $237,000 per year nationwide, while specialists make $341,000 per year, according to the bureau.

The coronavirus pandemic has hurt primary care practices as well. Patients delayed medical visits due to job and income loss or fear of contacting the novel coronavirus. These delays and cancellations created ongoing scheduling backlogs.

Also, prior to the pandemic, many patients hadn’t used a telehealth platform; both patients and primary care doctors had a learning curve to overcome.

The pandemic also created financial struggles for primary care practices. According to a recent report by Mathematica, a research firm, few primary care practices obtained federal loans through the Paycheck Protection Program.

The Kaiser Foundation found that primary care physicians also are overwhelmed with a huge amount of documentation required by insurers for a growing population of patients with chronic conditions and disabilities. The time required by primary care doctors per patient has increased significantly, with older patients complaining of multiple aliments.

To deal with the low pay and paperwork requirements, some primary care providers are offering concierge services, in which the patient pays an annual retainer fee to receive same-day appointments and even home visits for preventive and wellness care.

Concierge service cost from $2,500 to $10,000 per year, but may not include all your medical care.

According to Consumer Reports, the care covers only a narrow range of services; you’ll still need to pay the premium costs to maintain your regular health insurance to cover specialized treatments or catastrophic care.

Primary care doctors may be certified in family practice, pediatrics or internal medicine, and can include medical doctors, doctors of osteopathic medicine, physician assistants and nurse practitioners.

Andy Winnegar has spent his career in rehabilitation and is based in Santa Fe as a training associate for the Southwest ADA Center. He can be reached at a@winnegar.com.

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