Editorial: Everyone in Michigan should have a family doctor
Mackinac Island — Assuring that everyone has a doctor to call their own is a key element in improving health care, particularly in vulnerable communities.
Yet 25% of Americans don't have a primary care physician who they see regularly, and the percentage could be much higher in some rural and urban areas like Hillsdale and Detroit, which are designated health professional shortage areas.
Inequities in access to health care are blamed in part for the disproportionate impact of COVID-19 on minority communities. African Americans had a 40% greater incident rate of the virus compared to Whites last year, and have died at 2.0 times the rate, according to the Centers for Disease Control.
Closing the health care gap is a major focus this week of the Detroit Regional Chamber's Mackinac Policy Conference.
"When you have regular access to a health care professional who understands who you are as a person and your health care needs and the social and other factors that impact your health, it clearly improves the outlook for individual health and wellness," says Wright Lassiter III, conference chair and head of the Henry Ford Health System.
The benefit of having a family doctor — or a physician's assistant or nurse practitioner — a patient sees regularly is the trust and familiarity that develops over time.
Patients without a primary care physician tend to see a doctor only when they get sick, and if they're going to a walk-up clinic or emergency room it generally is a different doctor each time.
A family doctor provides ongoing health maintenance through regularly scheduled visits. And when a pandemic such as COVID hits, they are a vital resource for identifying symptoms and directing patients to appropriate care.
"It’s always been known that when you don’t have access to health care advice there are consequences," Lassiter says. "When we have an infectious disease outbreak, those who have health care professionals they can consult with fare better."
Just over 25% of medical students are choosing general practice, exacerbating a shortage of family doctors that has been building for decades.
"There's no silver bullet answer," Lassiter says.
Michigan is receiving nearly $11 billion in federal COVID relief funds. Gov. Gretchen Whitmer is proposing to spend some of that money to improve health care in underserved communities.
She and lawmakers should focus on developing a stronger network of primary care physicians in both urban and rural communities.
Financial incentives to encourage more medical students to choose family practice might help. The state should also consider relaxing licensing rules to make it easier for foreign doctors from countries with acceptable medical schools to practice here.
Lassiter says it is also essential to get more minority high school students into the health care careers pipeline.
"When individuals connect with a health care professional they identify with, it often produces better outcomes," he says.
The 2020 federal COVID relief package provided more funding for medical education, including 1,000 new Medicare residencies nationwide. But the cap on medical residencies overall is still too low. Congress should raise the limits, particularly for residencies at urban health centers.
More family doctors embedded in communities such as Detroit where health needs are the greatest is an essential step in closing the health-equity gap.