The primary care sector is the backbone of the health care system and the only one that works to increase life expectancy and reduce health inequalities. However, the American Medical Association’s Masterfile contains shortcomings that cause previous research on the distribution of physicians across geography and specialty to overstate the workforce. Researchers proposed a practical, systematic, and more accurate approach to identifying primary care physicians using the National Plan and Provider Enumeration System (NPPES) and the Virginia All-Payer Claims Database (VA-APCD). The NPPES was used to compile a list of every doctor in the state of Virginia, along with their specialization, from 2015 to 2019. Participating in at least 1 claim in the VA-APCD was the criterion for identifying active clinicians. The NPPES used a hierarchical system to determine the level of expertise of each practitioner. Non-family medicine doctors providing primary care were discovered through wellness visit data. There were 20,976 practicing doctors in Virginia in 2019. Of those, 5,899 (or 28.1%) were primary care physicians. The majority (52.4%) of this primary care physician workforce were general internists; the next largest group (18.5%) were internal medicine specialists; the next largest group (16.8%) were pediatricians; the last largest group (11.8%) were obstetricians and gynecologists, and the smallest group (0.5%) were other specialists. Primary care physicians have been pretty steady over the past 5 years in terms of absolute numbers and workforce percentages. Through their innovative approach, investigators could accurately determine the size of the primary care workforce in Virginia, which was significantly smaller than some earlier estimates. Planners, payers, and policymakers can use this straightforward strategy to guarantee sufficient primary care capacity; however, it should be broadened to include advanced practice doctors and to define the scope of practice more precisely.
Source: annfammed.org/content/20/5/446
