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Where Will Seniors Get Health Care

  • Published: 2010-12-04 : Author: American Academy of Family Physicians
  • Synopsis: More Than One in 10 Family Medicine Practices Consider Closing with Continued Threats to Medicare Payment.

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More Than One in 10 Family Medicine Practices Consider Closing with Continued Threats to Medicare Payment.

At a time when 56 million Americans struggle to gain access to primary care doctors, more than one in 10 family physicians face the prospect of closing their offices if Medicare slashes their payment next year, according to a recent survey of American Academy of Family Physicians members who have an ownership stake in their medical practices.

For seniors, that will make seeing a doctor even more difficult.

The AAFP survey asked family physicians about the impact of the 25 percent Medicare pay cut required by law to take effect Jan. 1. The results showed that nearly 13 percent of respondents would consider no longer seeing any patients, more than six out of ten (62 percent) said they may be forced to stop accepting new Medicare patients, and more than seven in 10 (73 percent) said they would have to limit the number of Medicare appointments.

The results paint a bleak picture for elderly and disabled Americans who depend on Medicare for their health care coverage and for military families who depend on TRICARE, according to Roland Goertz, MD, MBA, president of the American Academy of Family Physicians.

"This survey demonstrates the serious threat to Americans' access to health care that is posed by the current formula for paying physicians to care for the elderly and disabled," Goertz said. "The most vulnerable Medicare patients are people in rural areas who are at risk of completely losing access to care if a practice in their small community closes."

Goertz pointed to an Oct. 13 AARP survey that showed 81 percent of AARP members who receive Medicare and 86 percent of members not yet eligible for Medicare are concerned about the impact of the Medicare physician pay cut on their access to a doctor.

"Americans understand the threat that Medicare pay cuts pose for their own health care and the health care of their loved ones," said Goertz.

Family physicians are the primary source of medical care for 60 percent of people age 65 and older who report having an individual health professional as their usual source of care. Elderly and disabled Americans in rural and underserved areas, where family physicians often are the only health care professionals in town, would be particularly hard-hit.

But slashing Medicare payment to physicians threatens just such a loss, particularly for rural Americans, according to AAFP survey respondents:

"Medicare cuts would destroy my practice of geriatric medicine," said one respondent.

"The 21 percent-plus Medicare cut would most likely put us and other small practices out of business and force us to eventually close our doors to our patients, because, soon after the Medicare cut comes, all commercial insurance will follow suit as their fee schedule is based on Medicare's," wrote one survey respondent. "And forget about getting care if you have TRICARE. Which, as a veteran myself, is an outrage."

Others have already thrown in the towel.

"I have made a decision to close my practice," wrote one respondent. "I am losing my shirt. This game with SGR is silly."

The stagnant Medicare payments during 10 years of inflation have taken their toll on family physician practices. Many family physicians have remained open by cutting expenses, including their own salaries.

"Already closed one satellite office," wrote one respondent. "Currently I'm in the red simply trying to stay afloat. Just liquidated my entire retirement IRA to pay office expenses/accountant and do not see any possible way to remain in business."

"My partner and I did not pay ourselves last month due to the delay in Medicare payments," said one respondent.

More than 56 million rural, urban and suburban Americans are classified as "medically disenfranchised" because they have no access to primary health care, according to research by the Robert Graham Center for Policy Studies in Family Medicine and Primary Care and the National Association of Community Health Centers. The NACHC also reports a significant shortage of primary care doctors, nurse practitioners and other health care professionals. The loss of family physicians would be devastating to Americans in primary care shortage areas, Goertz added.

"We have reached a point where all patients "children, their parents and their grandparents "face the real prospect of losing their doctors," said Goertz. "Medicare "the program designed to ensure that our elderly have access to health care "could force the very doctors who care for them out of business. And if that happens, all patients in that community "regardless of their insurance coverage "would lose access to needed health care."

About the American Academy of Family Physicians -Founded in 1947, the AAFP represents 94,700 physicians and medical students nationwide. It is the only medical society devoted solely to primary care.

Approximately one in four of all office visits are made to family physicians. That is 228 million office visits each year "nearly 84 million more than the next largest medical specialty. Today, family physicians provide more care for America's underserved and rural populations than any other medical specialty. Family medicine's cornerstone is an ongoing, personal patient-physician relationship focused on integrated care.

To learn more about the specialty of family medicine, the AAFP's positions on issues and clinical care, and for down-loadable multi-media highlighting family medicine, visit For information about health care, health conditions and wellness, please visit the AAFP's award-winning consumer website,


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