By Anne Dabrow Woods, DNP, RN, CRNP, ANP-BC, AGACNP-BC, FAAN, Chief Nurse, Wolters Kluwer, Health, Learning, Research and Practice
Twitter: @Wolters_Kluwer
In the not-too-distant past, patients primarily received care at a brick-and-mortar provider’s office for their primary healthcare needs, for sick or prevention visits or chronic condition management. But a number of economic and societal factors have caused a real revolution in where patients receive care. Today’s patient may go to a hospital, long-term care, rehabilitation, standalone clinic, retail clinic in a pharmacy, urgent care, or even receive care virtually or at home. Where they go depends on the nature of the care they need.
In the coming years, it’s projected that 26% of outpatient visits will be done virtually and 30% of inpatient volume could shift to at-home care. But as consumers demand new health experiences, we must examine whether our care delivery system can keep pace with: 1) the changing landscape and shifting clinicians’ roles, 2) a focus on the whole person, and 3) optimal wellness models.
Factor #1: The changing landscape of patient care
Broader access to care profoundly influences the healthcare landscape’s future. While consumer preference is a driver for ease and convenience, the lack of primary care physicians is another key factor influencing the shift. A study by The Association of American Medical Colleges (AAMC) projects the shortage of primary care physicians at between 17,800 and 48,000 by 2034, with a shortfall of non-primary care specialty physicians at between 21,000 and 77,100 during the same timeframe.
This shortage of physicians has a trickle-down effect, with nurse practitioners, physician assistants, nurses, and other support staff all being called on to fill the gaps. How much more can these clinicians do? While nurse practitioners and physician assistants have long been trusted primary care providers, nurses have traditionally filled the caregiver role. Moving forward, they will take on an even larger role as more care services are delivered in retail pharmacies and other settings. With patients looking for more convenient access to care, providers and caregivers are stretched to the limit in many care areas. While the shortage of direct caregivers is most noticeable in acute and long-term care, staffing issues in other locations must also be addressed to maintain quality care and prevent burnout.
Implications of a generational shift in care
We know that baby boomers, for the most part, have invested in a relationship with their primary care provider. They rely on their provider’s judgment and don’t mind waiting for an appointment. Enter the younger generations who don’t have this same bond. In many ways, the site-of-care shift has been driven by the care preferences of Millennials and Gen Zs. A recent survey commissioned by Wolters Kluwer found that 70% of Millennials are ready to rethink the “who and where” of primary care.
Factor #2: Patients want a “whole person” approach to their health
Today’s patients understand “it takes a village.” They see their health as a hub with them at the center, surrounded by a coordinated network of healthcare services and other wellness, behavioral health, or other personal and social services. They expect a team-based system to achieve improved health outcomes.
Rather than dealing with a handful of unrelated providers who may not be aware of what’s going on with one aspect of their health, patients want a connected and multidimensional approach. This may consist of some hospital or clinic-based services, telehealth, and home services — with the overall mission to deliver seamless care that places the patient at the center.
Factor #3: Optimal wellness as a result
A more holistic view of health integrates not just disease or chronic condition treatment but also prevention and wellness. Can health be optimized with a shift in habits, making nutrition or exercise changes? What about mental and social needs, along with physical needs? Whether clinic-based or virtual, all components must work together to achieve better and more sustainable health outcomes.
With access to care continuing to evolve and patients getting more and more savvy and engaged in their own health, the healthcare we deliver is changing, too — becoming much more individualized, regardless of setting. As part of this shift, we must recognize that there won’t be a one-size-fits-all model. We must refocus our models on the consumer, with nurses, nurse practitioners, physician assistants, pharmacists, physicians, and other healthcare professionals bringing their unique knowledge and experience to patient interactions. Working collaboratively as a care team can help ensure a highly coordinated, safe, and personal care experience for patients – regardless of where they seek treatment.