Nearly a third of primary care doctors still have no idea when or whether their practice will get the COVID-19 vaccine to administer to patients, according to a new survey.
So far, primary care has been a largely untapped resource in the vaccine rollout, with 32% of doctors saying they have not been included in any state or regional distribution planning.
Another quarter say they are waiting for delivery of the doses. Less than a fifth (19%) say they are currently administering the COVID-19 vaccine, according to a survey of 1,000 primary care clinicians conducted by The Larry A. Green Center in collaboration with the Primary Care Collaborative and 3rd Conversation.
The survey was conducted from Jan. 15-19. The Biden administration has been taking steps to increase vaccine supply since President Joe Biden took office. This week, the administration began to roll out vaccines to federally qualified health centers to help reach underserved and vulnerable communities. The administration also said it will increase the vaccine supply to states by 5% over last week and has increased supply by 28% since Biden came into office three weeks ago.
Eight in 10 primary care practices indicated they are ready and willing to assist with COVID-19 vaccine distribution, despite ongoing staffing shortages caused or exacerbated by pandemic-related financial issues, the survey found.
For some, the difference is being part of a health system; 44% report that their local health systems can get the vaccine, but small or independent practices cannot. A majority of respondents believe primary care should be partnering with public health (65%) and local health systems (62%) in COVID-19 vaccine delivery, according to the survey.
Most clinicians (89%) say they have received at least one dose of a COVID-19 vaccine. Now, only 6% of respondents say they can’t get the vaccine for their practice's clinicians or staff. Yet vaccine hesitancy exists even among primary care: 13% report having clinicians in their office who are against use of a COVID-19 vaccine.
As the largest healthcare platform in the U.S., primary care has the potential to turbocharge distribution if resources are put in place to enable practices to join the effort, industry leaders say.
Primary care doctors are increasingly concerned that their practices are being left out of the vaccine rollout and believe this puts patients' health at risk.
"We are incredibly frustrated. Our six-doctor practice could easily be giving out 300 vaccines per week but we cannot get the vaccine (or information about the vaccine) other than an initial 200 doses for healthcare workers," a primary care doctor in Texas said, according to the survey.
Another Texas doctor said, "It doesn't appear anyone wants to deal with community-based primary care providers. They are only working with large pharmacies and hospital systems that don't have the trust of patients that community physicians have. Many of my patients refuse to go there even when I try to reassure them. They just don't trust those entities."
“With sufficient support to help clinicians with the necessary infrastructure, primary care is ready to meet the administration on the front lines of the effort to promote, educate and administer the vaccine,” said Rebecca Etz, Ph.D., co-director of The Larry A. Green Center, in a statement. “Primary care can act as a superhighway to distribute the COVID-19 vaccine; however, all signs continue to show systemic exclusion of the existing primary care infrastructure that vaccinates 46% of the adult population and 72% of the pediatric population every year.”
The survey also found that primary care practices are doing what they can to support the COVID-19 vaccine, including by referring patients to a known source when they call to ask for a vaccine (47%) and sharing educational information with patients (42%). About 30% of doctors say they are proactively notifying all their patients about how to get the vaccine.
“The science of innovation adoption tells us that vaccinating the population at scale will necessitate focusing on people who are worried and have questions—which, let’s be honest, is the majority of us,” said Christine Bechtel, co-founder of 3rd Conversation. “When it comes to health questions, the first place patients think to go is their primary care doctor’s office. It will be another tragedy in a long line of missteps if we don’t equip these trusted doctors with the vaccine and resources they need to reach so many individuals in our communities.”
Docs face financial strain
Practices continue to face financial stress and staffing shortages during the pandemic. According to the survey, 55% of clinicians report that the current surge is “much worse” than any previous point in the pandemic. A not insignificant portion of clinicians (15%) personally know primary care practices that have closed, and 35% personally know clinicians who have quit or retired early because of the pandemic.
"This last quarter was by far the worst I have had in 18 years. The financial pain in primary care practices right now is real—and unsustainable if things do not change," a primary care clinician in Virginia said.
Another clinician based in Virginia said, "It is hard to overemphasize the severity of staffing shortages. We are running our clinic on bare-bones, at precisely the time when demand is highest."