Delaware Public Media

Primary care practices continue decline statewide

Jan 2, 2019

A recent study shows what some are calling a critical shortage of primary care physicians in Delaware.


The study was commissioned by the state and conducted by the University of Delaware. An approximate 815 primary care physicians were counted as practicing in the First State in 2018 with 662 working full-time.

That’s a 10% drop from 2008 and survey data indicates the downward trend will likely continue.

And doctors say many existing primary care practices are switching to concierge service where they charge a monthly fee and see fewer patients.

Wilmington Primary Care Physician Dr. James Gill calls Delaware the worst state in the country for primary care practices.

“So Delaware primary care physicians have one of three choices: they either go out of business, they move to another state that pays more, or they move to this concierge model,” said Gill.

Delaware’s Secretary of Health and Social Services Dr. Kara Odom Walker points out the care coordination provided by primary care is an important part of the state’s plans to implement a health care spending benchmark.

“We’re not necessarily at a crisis point,” said Walker. “But I would say when you’re coupling the health issues in our state with the opioid crisis we definitely need to pay attention and really think about our workforce strategy going forward.”

Kent and Sussex Counties have the most need. Both have a ratio of more than 2,000 patients per primary care physician which qualifies as a federally designated shortage area.

And Medical Society of Delaware President Dr. Andrew Dahlke says Delaware’s aging population is likely to exacerbate the problem in the years to come.

“We’ve got all these baby-boomers that are coming up,” said Dahlke. “It’s called the great tsunami. The biggest glut of baby boomers is going to turn 65 in five years and we’re going to need even more physicians by then.”

A new Delaware law requires private insurance providers to pay primary care physicians at least as much as the Medicare rate, but doctors say neighboring states still pay more.

The data shows 70% of a Delaware primary care physician’s time is spent serving Medicare and Medicaid patients, while those populations represent less than 25% of the population.

The Delaware Health Care Commission is finalizing recommendations in the next week for the General Assembly to further reform payment policy for PCPs in the state. Online public comment on the matter is open until January 7th.