Access to Primary Care in Oregon: Challenges and Outlook

Marquita Hannan’s experience underscores the increasing difficulty in accessing primary care in the Portland area. Last fall, during a medical issue related to her pregnancy, she couldn't secure a timely appointment at her clinic, leading her to visit the emergency room. When her daughter fell ill weeks later, a prolonged wait for a clinic appointment resulted in another emergency room trip for a pneumonia diagnosis.

These incidents resonate with nearly half of 600 voters surveyed in Multnomah, Clackamas, and Washington counties. According to the poll by DHM Research, commissioned by The Oregonian/OregonLive, 47% of respondents experienced increased difficulty securing primary care physician appointments compared to the previous year. Access to specialists and mental health services has reportedly become more challenging as well.

Despite improvements since the pandemic peak, significant access issues persist, notes Michelle Neiss, president of DHM Research. She explains that while most Oregonians have health insurance, rising costs are obscured by employers absorbing premium hikes, leading to higher deductibles and out-of-pocket expenses for policyholders.

Dr. Jane Zhu, a healthcare access expert at Oregon Health & Science University, notes these challenges are widespread, affecting various demographics and areas. She emphasizes that this systemic issue extends beyond Oregon, impacting diverse income levels and geographies.

The poll highlights that Oregon's primary care system is strained due to retirements, fewer new entrants into family medicine, and a payment structure disproportionately favoring specialty care. Betsy Boyd-Flynn from the Oregon Academy of Family Medicine Physicians stresses the need for immediate system stabilization to prevent further degradation.

For patients like Hannan, resource strain in healthcare is evident. Appointment delays for her children and insurance limitations on medical devices illustrate broader systemic issues. Yet, for Portland resident Marcus Streipes, switching insurance carriers resolved previous access challenges.

Vincent Olivetti shared similar access difficulties, citing insurance coverage issues for essential medical devices after a stroke. He highlights the financial burdens on insured families due to copays and uncovered services, echoing Dr. Zhu’s observations. According to Olivia Kosloff of the American Economic Liberties Project, healthcare industry consolidation is affecting costs and reducing patient choice, although Dr. Zhu believes improvements are possible with statewide accountability and commitment. This offers a hopeful outlook for the future of healthcare access.