Doctor-patient bond key to healthy aging

Medicine means more than managing symptoms and mending wounds.

Primary care develops a picture of patients’ overall health.

Residents seize this opportunity locally, as Sumter County has the highest percentage in the state of adults with a personal doctor.

That’s good news, as research suggests primary care helps people live longer, healthier lives. But a recent study found the number of people with it nationwide is declining, and experts are concerned about the repercussions that could have on the health care system and the health of the individual.

Attention to preventive care is important for all age groups, and especially for older adults, said Dr. Robert Reilly, medical director of utilization management for The Villages Health.

“As we age, there is a greater likelihood of developing medical conditions, even if we have been healthy for most of our lives,” he said.

Approximately 85% of older adults have at least one chronic health condition, and 60% have at least two chronic conditions, according to the Centers for Disease Control and Prevention, and the population of older Americans continues to rise.

“What everybody needs is a primary care doctor,” said Dr. Elliot Sussman, chairman of The Villages Health. “He or she needs to be the quarterback in service to their patients.”

It’s estimated that Sumter County has the highest percentage in the state of adults with a personal doctor, according to a telephone survey conducted by the CDC and the Florida Department of Health. About 90% of adults say they have a doctor, while the state’s average is an estimated 72%.

Sumter County’s rate is boosted in part by having many older residents who qualify for Medicare, which covers an annual wellness visit. The Villages metropolitan statistical area, which includes all of Sumter County but not The Villages in Lake or Marion counties, has the highest median age of any U.S. metro area at 67 years old. It also leads the nation in Medicare participation, with 60.9% of residents on Medicare, according to census data.

An estimated 94.9% of Sumter County residents have health insurance coverage, according to the CDC and FDOH survey.

Nationally, though, 27.5 million Americans did not have health insurance in 2018, according to the U.S. Census Bureau. 

Primary care has decreased nationwide for every decade of age except for Americans in their 80s, according to a recent study by researchers at Harvard Medical School, meaning some with Medicare coverage choose to forgo primary care.

In 2002, 82% of Americans in their 60s who had one or no chronic conditions had primary care. Thirteen years later, the number dropped to 73%, the study found.

“Primary care is the thread that runs through the fabric of all health care, and this study demonstrates we are potentially slowly unweaving that fabric,” said Dr. David Levine, Harvard Medical School instructor in medicine and co-author of the study, in a release.

Studies show patients with access to a regular primary care physician have lower overall health care costs.

Those who build an ongoing relationship with their providers also have better health outcomes.

Continued communication helps patients feel comfortable bringing up concerns that might seem minor, but actually imply a bigger health issue, Reilly said.

“Additionally, when a primary care physician knows you, he or she is far more likely to be able to pick up subtle changes in your health status,” he said. “Having a strong relationship with a primary care physician will help older patients navigate a complex medical system and feel assured that they have a true advocate in their care.”

Lack of primary care isn’t a problem specific to the United States, said Verena Menec, a professor in the Department of Community Health Sciences at University of Manitoba, because the mindset extends to medicine in nearly every country.

To discourage this trend in America, the Harvard study’s authors suggest lawmakers create incentives for new doctors to enter primary care and increase the proportion of Americans who have health insurance.

“We focus on the treatment,” Menec said. “I think we absolutely need to focus more on prevention.”

Senior writer Ciara Varone can be reached at 352-753-1119, ext. 5395, or ciara.varone@thevillagesmedia.com.