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The growing need for patient engagement in primary care practices

In part one of a three-part series on trends in healthcare consumerism, we examine the growing need to engage or bring back patients, deferring care and patient engagement tools.


Due to an ever-changing healthcare landscape, including the many shifts brought about by the COVID-19 pandemic, primary care providers are increasingly prompted to meet evolving patient engagement needs.

At the same time, urgent care clinics are becoming more popular for their convenience and accessibility, as are telehealth services that allow physician practices to increase their revenue by introducing it into their practices.

What remains the same is a high rate of physician burnout1 paired with a shortage of primary care doctors and facility staff, often making it challenging to meet patient demands.

The good news? Through innovative services and engagement tools, primary care practices can engage patients to come back and help improve healthcare outcomes.

The growth of urgent care clinics

Many communities have witnessed an increase in urgent care facilities. Offering same-day visits and quick access to treatment, these clinics saw a marked increase during the pandemic — although their growth has been trending for a while.

In fact, the urgent care business has more than doubled in four years growing from $15 billion in 2017 to $38.5 billion in 2021.2 And according to a 2021 Health Industry Distributors Association (HIDA) report, their continued growth is the result of:3

  • A shortage of primary care physicians
  • Increased insurance incentives
  • Accessibility

Samuel Werner, D.O., a family practice doctor and adjunct professor at Rowan University School of Osteopathic Medicine in New Jersey, says, "I think that's overall a net positive for the American people and for our health, to have ready access to medical care, hopefully of a high-quality level."

Urgent care vs. primary care

As urgent care industry trends reveal massive growth, two-thirds of urgent care facilities plan to expand their services to include:

  • Occupational medicine
  • Primary care
  • Specialty services such as allergists, weight management and medical spas

Meanwhile, primary care physicians keep non-emergent patients out of the emergency room while providing same-day medical attention and offer ongoing service relationships that urgent care clinics cannot provide.

Still, the challenge for primary care providers remains: How can we increase access to primary care and make our model appealing to the next generation of healthcare consumers?

Patient engagement in primary care

Patient engagement in primary care requires addressing:

  • Accessibility. Practices should consider having extended hours during the week or offering bimonthly Saturday hours. Werner says access is ultimately the key for any primary care office that doesn't want to get left behind
  • Availability. On average, the wait time for an initial primary care provider is 24 days. Young adults often choose appointments at urgent care facilities, which are available seven days a week
  • Relationships. Werner recommends more extended visits to get patients into the office to build those primary care relationships. In the past, it's been hard to accommodate more extended visits without payer reimbursement
  • Cost and care transparency issues. Rising healthcare costs may drive healthcare consumers to urgent care clinics due to readily available costs and transparent care options

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Younger generations choose convenience over relationships

Younger adults visit primary care physicians far less often than older generations do, even among those who have access to their primary physicians.

According to Ronald Dixon, M.D., an internal medicine physician in Boston and the founder/CEO of health technology company CareHive, "Urgent care can never replace office-based primary care."

Still, younger generations tend to prioritize convenience and technology4 over relationships and expect an efficient infrastructure.

According to one study:5

  • Only 55% of Generation Z (born between 1997 and 2012) have a primary care physician
  • Of those who do have one, 40% see their primary care doctor once a year, rarely or never
  • Only two-thirds of millennials surveyed had a primary doctor
  • One-third of millennials who have a primary physician see their doctor once a year, rarely or never

Younger healthcare consumers are also interested in care models that optimize technology services, including:

  • Virtual health visits
  • Email or text reminders
  • Remote healthcare monitoring technology
  • Electronic prescription refills
  • Digital test results

However, all is not lost. Dixon says, "There are still some young people who want a relationship and older people who don't," Dixon says. "And you can still have that relationship through telemedicine."

Patient & family engagement in primary care practices involves fostering relationships

One of the most essential and un-replicable primary care healthcare components is an ongoing relationship between provider and patient. Regularly seeing the same doctor builds trust, and in turn, the doctor has a sense of patient needs and medical history.

One way to make patients feel heard is to offer more extended visits. By spending more time with each patient, doctors can convey a sense of care and attention not previously felt during shorter visits.

Studies show that sitting with the patient, rather than standing, adds to the patient's perception of how long the doctor is present.6

To fully focus on the patient, there are other ways to document the visit while speaking directly to the patient:

  • Bringing a scribe into the room
  • Using a virtual online scribe
  • Dictating after the visit

"In our rush to adopt a more efficient method of documentation, we have to make sure patients aren't left behind," Werner says.

Healthcare consumers value cost transparency

Primary care practices must prioritize financial transparency and be willing to explain costs to their patients.

To help reduce cost-related issues, consider:7

  • Utilizing an outside revenue cycle management system (RCM) to handle billing with insurance companies and patients
  • Explaining the "why" behind costs to patients, particularly why they need more expensive treatment for their healthcare

How physicians can build trust with their patients

According to a Stanford University research report, the patient/provider trust relationship comes down to five key points:8

1 | Prepare. Providers should make sure they are ready for appointments with patients and have clear goals for the encounter

2 | Listen intently. Practice active listening skills and do not interrupt the patient

3 | Agree on priorities. Discuss shared treatment goals with the patient

4 | Connect with the patient's story. Physicians should contextualize clinical goals within the patient's personal life

5 | Explore emotional cues. Doctors should observe patient behavior and respond to emotional cues with empathy

The evolution of primary care practices

Primary care practices must adapt to the changing trends in healthcare and the ever-evolving needs of their patients to retain existing patients, engage them in regular care and attract new patients to their practices.

By responding to the wants and needs of younger generations while continuing to improve the care of older patients, primary care practices will maintain their place as an indispensable source in the healthcare sphere.

For a complete picture of the latest trends in healthcare consumerism, read part two concerning the growing use of technology and part three about the growing focus on wellness.


1: https://www.healthcareitnews.com/news/pandemic-era-burnout-how-physicians-manage-crushing-workloads-and-it-demands
2: https://www.d2ihc.com/urgent-care-trends/
3: https://www.hida.org/distribution/research/market-reports/Physician-Market-Report.aspx
4: https://www.accenture.com/us-en/insights/health/todays-consumers-reveal-future-healthcare
5: https://www.phillyvoice.com/health-care-trends-generation-z-millennials-primary-urgent-care-telemedicine
6: https://pubmed.ncbi.nlm.nih.gov/21719234/
7: https://patientengagementhit.com/news/5-principles-to-build-positive-patient-provider-relationships
8: https://amazingcharts.com/2021/10/27/building-patient-trust-in-an-out-of-the-office

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