Dartmouth Researcher Challenges AMA Data
In the wake of healthcare reform, data is becoming more important than ever in issues such as the need for primary care physicians.
The findings of a recent Dartmouth Institute for Health Policy and Clinical Practice report say mortality and hospitalizations are significantly lower in areas where there are more primary care doctors who work fulltime and are taking care of patients in ambulatory care and office settings.
Looking past those general findings, however, reveals other issues. The report also takes aim at the American Medical Association's database of physicians and questions the accuracy of its findings, and its breakdown of primary care physicians in certain areas, the co-author told me. Ironically, the Dartmouth study is published in the Journal of the American Medical Association.
"The (data) that the AMA is using to estimate the number of primary care doctors is not accurate," say Chiang-Hua Chang, MS, PhD, an instructor in Dartmouth Institute for Health Policy and Clinical Practice. "What the AMA is using does not accurately reflect what the doctors are doing." What the listed primary care doctors are actually doing, says Chang, is "going into subspecialties."
Essentially, "primary care doctors listed on AMA are not all doing primary care, many of them are actually providing specialty care," she says.
Recognizing the difference is not only important to improve primary care clinician measurement, but also reflects the drift of physicians into nonprimary care careers. The manner in which primary care physicians are practicing is important in the healthcare reform era, especially with the established great need for primary care physicians. As Chiang-Hua Chang noted, the training capacity of family medicine and internal medicine may have "disappointing patient benefits if the resulting physicians are primary care in name only."
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