Patient Health Declining, New Primary Care Survey Shows

Practices Also Burdened With Unresolved Challenges From Earlier Pandemic Surge

WASHINGTON, November 19, 2020 – Primary care patients are showing the effects of delayed or inaccessible care, according to a survey of clinicians conducted in mid-October, seven months into the pandemic. The results of the survey were released today by the Larry A. Green Center, a research organization, in collaboration with the Primary Care Collaborative (PCC) and 3rd Conversation. Over half (56%) of the clinicians in the survey reported seeing declining health among their patients caused by closed primary care settings and care being delayed or deferred during the pandemic.

These findings come as COVID-19 cases spike in most states and the healthcare system sees signs of again being pushed to its limits. The survey also assessed the state of primary care practices, which continue to deal with the consequences of the first COVID-19 surge. These include the inability to fill open staff positions (35%), persistent challenges with COVID-19 testing (61%), and inadequate supplies or not having proper PPE (37%).

“It was great to hear positive news this month regarding new vaccines on the horizon. Primary care is the most likely front line to distribute the vaccine, and yet we continue to ignore its sustainability,” said Rebecca Etz, PhD, co-director of The Larry A. Green Center. “Primary care is essential to our national health, and it requires essential funding to safeguard care teams while they safeguard us.”

“If we are going to be successful in managing this next wave of the pandemic and responding to patient need, we will need a more robust primary care system,” said Ann Greiner, President and CEO of the PCC. “Public and private payers can create more stability in primary care by committing to appropriately set prospective payments and maintenance of telehealth at parity with in-person visits until the vaccine is widely disseminated.”

“These survey results are sounding a very loud alarm bell that I hope everyone hears,” said Christine Bechtel, patient advocate and cofounder of 3rd Conversation. “After the first pandemic wave, around one in ten primary care practices was predicting closure, and 40% had laid off staff. Are we going to let that happen again? President-elect Joe Biden’s COVID-19 taskforce has an opportunity to do what no leaders have yet done: target resources to primary care so that the backbone of the U.S. health system survives when we need it the most.”

The survey was conducted by the Larry A. Green Center, based in Richmond, Virginia. The survey is part of a regular Green Center series to look at the attitudes of primary care clinicians and patients during the COVID-19 pandemic and the abilities of practices to meet patients’ needs.

The survey of clinicians received 582 responses from 47 states and Guam. It was conducted Oct. 16-19, 2020. 66% of respondents identify their practice as family medicine, 15% as internal medicine, 6% as pediatrics, 5% as geriatrics, 2% as mental health, and 6% as other. Settings include 20% rural, 9% community health centers, and 7% in schools/offices. 30% have 1-3 clinicians in the practice, and 40% have more than 10 clinicians. 42% are owned by a health system, 29% are self-owned, 17% are independent and large-group, and 4% are government-owned. 6% are convenience settings, and 4% are membership-based.

More information about the survey

Experts are available to provide insight and comment on the survey:
  • Ann Greiner, president and CEO of the Primary Care Collaborative
  • Rebecca Etz, PhD, co-director of The Larry A. Green Center
If you would like to speak with them, please contact Stephen Padre (Primary Care Collaborative's communications manager),, 202-417-3911

About the PCC

About The Green Center:

The The Larry A. Green Center for the Advancement of Primary Health Care for the Public Good is a research group founded by Rebecca Etz, PhD at Virginia Commonwealth University and Kurt Stange, MD, PhD at Case Western Reserve University. The Green Center works to reclaim and reconstitute the intellectual foundations of primary care, to advance the science of medicine learned and practiced within layered and competing social frameworks of meaning, and to deliver on a now 50 year old promise: better health and improved health care through a synergistic focus on both humanism and healing. We are nimble, inquisitive, curious, and open. We make personal doctoring and innovation visible.

About 3rd Conversation:

3rd Conversation is a national initiative reimagining the future of health care by reinventing the provider-patient relationship for the modern era. Powered by X4 Health, 3rd Conversation works at both the local and national levels to address health professional burnout, improve patient experience and realize the promise of humanity and connection in our health care system. Funding support is provided by the Morris-Singer Foundation.

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