The United States is going through an increasingly urgent healthcare crisis that was accelerated during the Covid-19 pandemic. The Great Resignation, which saw millions of Americans leave their jobs in search of better work-life balance and more satisfying jobs, has hit the healthcare sector. Burned out workers have quit en masse in search of more flexible work hours and more satisfying work conditions. Reports show that 20% of healthcare workers have quit their jobs, including 30% of nurses, with 28% of healthcare workers citing burn out as a major factor. This crisis has gutted the primary care system, impacting the ability of seniors to receive the primary care they need. Deep reforms have to be made. Here’s what we need to do to reinvent primary care for seniors.
The United States spend just 5% to 7% of its healthcare spending on primary care, despite the importance of primary care in disease prevention, improving health, and reducing mortality rates. Spending for primary care aimed at seniors is even lower. The result is that seniors are left exposed to the kind of massive crisis that the pandemic brought, without access to the best primary care physicians, because of huge workloads. The typical primary care physician is in the invidious position of dealing with more and more patients as more and more primary care physicians leave. Burnout is the logical consequence and for many primary care physicians, the solution is to resign. The system is caught in a cycle, and it’s a cycle that is getting worse as Baby Boomers age. The first solution then is to increase investment in primary care for seniors.
Adopt a More Holistic View of Health Care
Healthcare is not just about providing medical care. It is necessary to view healthcare in terms of possible triggers of negative as well as positive health outcomes. This demands getting to know seniors within the context of their communities, not just as patients in a practice. According to Humana, seniors enrolled in Medicare Advantage have health-related social needs, such as financial strain (a third of seniors), food insecurity (18.5%), and poor housing quality (17.7%) the most widely reported. Many seniors also lack access to transportation, which prevents them from accessing good primary care. Consequently, an increase in investment must not simply be directed at medical needs, but at health-related social needs.
Research shows that 80% of health outcomes are driven by these health-related social factors, and medical factors account for just 20%. Addressing these social determinants of health (SDOH) is vital to improving health outcomes for seniors. Physicians have long despaired that they lack the time or resources to address SDOH. It’s estimated that only 16% of physicians screen for SDOH. Such is the state of primary care. We need to ensure that more dollars address SDOH so that seniors enjoy the most efficient health care possible.
This money could be spent not just on facilities and infrastructure, but on training physicians to screen for SDOH and to reform the fee-for-service compensation model so that physicians are incentivised to screen for SDOH.