More Primary Care Physicians Could Result in Increased Life Expectancies, HMS Study Finds

Harvard Medical School researchers found that increasing the number of primary care physicians in underserved areas may boost life expectancies, according to a study published Tuesday in Annals of Internal Medicine.

The study analyzed primary care physician density and population mortality data from 3,104 U.S. counties between 2010 and 2017. Based on that data, researchers projected that increasing the number of primary care providers in a county without sufficient healthcare resources would lead to a 9 percent increase in life expectancy.

Sanjay Basu, the corresponding author of the study and Director of Research at the HMS Center for Primary Care, said a 9 percent improvement in life expectancy is “pretty dramatic.”

“That’s at the level of what we see from reductions in smoking, for example tobacco smoking, in prior years,” Basu said. “It’s much bigger than all the innovations that have happened in cancer therapy — in history.”

Russell S. Phillips, the director of the HMS Center for Primary Care and co-author of the study, said the findings highlight the fact that “primary care saves lives.”

Basu noted that the effectiveness of increasing the number of primary care physicians varies based on the socioeconomic contexts of different regions.

“If you had one more doctor in Boston, it doesn’t make that much of an impact,” Basu said. “If you add one more doctor in the Central Valley of California, it makes much more population impact. It’s because they’re starting from such a low level.”

Despite the life-saving potential of primary care, Phillips said there is a “dramatic shortage” in primary care physicians across the country.

“What was surprising to me is how many doctors we actually need, or how many primary care clinicians we need in underserved counties to really optimize life expectancy and mortality — and came up with a number of almost 95,000,” he said.

Shari M. Erickson, the vice president for governmental affairs and medical practice of the American College of Physicians, said many primary care practices were forced to shut down or cut back due to their inability to manage the increased volume of need during Covid-19.

Phillips, a primary care physician himself, said he believes the pandemic has “emphasized the importance of primary care” because many patients’ first contact with a physician is often their primary care doctor. Many primary care providers have thus been “overwhelmed” by patients seeking care for Covid-19.

Basu said some changes are already being made to health care policies across the country. Medicare, for instance, is starting to implement “value-based payments” in which physicians are paid for the quality of their service rather than quantity of visits.

“It tries to align financial incentives with actual health improvements, rather than doing more visits, even if those are actually improving health,” Basu said.

Massachusetts is currently drafting legislation that would allow every resident to access primary care, according to Wayne J. Altman, a professor of family medicine at Tufts University Medical School.

“If we apply this article to this population of people, we’re extending people’s lives, just by virtue of having care, not to mention the fact that we’re going to decrease cost of overall care and decrease health disparities by providing that access,” Altman said.

—Staff writer Ariel H. Kim can be reached at ariel.kim@thecrimson.com.

—Staff writer Anjeli R. Macaranas can be reached at anjeli.macaranas@thecrimson.com.