A recent study found that some 30% of U.S. adults delayed primary care during the pandemic, and as yet, society hasn’t realized the public-health ramifications of it. What is clear is that any negative results on an individual level will have a knock-on effect in corporate America.

The results from that peer-reviewed study echo the results of one published in August 2021 by One Medical, a membership-based primary care practice that more than 8,000 companies use as a benefit for employees. Josh Dunsby, PhD, the company’s VP of client advocacy and consultant relations, says that while deferred health care is declining this year, there is a still a backlog. And behavioral health issues, which were exacerbated during the pandemic years, continue to be a problem for people. There is a shortage of providers, of providers who accept the insurance a person has, and often long waits to find a therapist or counselor to deal with mental health concerns.

There is an answer, though: to return the focus to primary care, which Dunsby calls the “front door to well-being.” The One Medical survey found a desire by employers for primary care to pay a bigger role in caring for employees and become the “foundational partner” for navigating the larger health care system.

Primary Care for the Win

The One Medical survey posed questions about health care to more than 1,600 people–half of them HR executives and half workers–and found that 9 in 10 believe that primary care is important to maintaining good health. About 85% felt that robust primary care can save money spent on health care over all, and two-thirds of executives felt that good primary care can reduce sick days and increase productivity. The percentage of workers agreeing with the last two items was significantly higher: 82% and 90% respectively. The survey reports that a large majority of workers and HR executives believe regular visits with primary care doctors is a win-win for both company and employee, with less money spent by the former, and better health and well-being for the latter.

Dunsby said primary care is not just for getting vaccines and checking blood pressure–rather, it can be a method of better controlling chronic conditions and the first stop for patients with behavioral health needs.

Many primary care doctors don’t regularly screen for depression and anxiety, but it is a regular feature of One Medical annual exams, Dunsby said, and given the level of both conditions in the lingering Covid era, that’s extremely important. Primary care physicians can prescribe medications to help combat conditions, but also help the patient develop a plan, whether it’s   finding a therapist or getting outside to exercise or taking “me time” to decompress from the pressures and stressors of life.

Recognition of the need for better mental health care started before the pandemic, said Dunsby. An August 2022 report from the Business Group On Health revealed businesses’ long-term concerns about mental health and desire to address the issue in the coming year. Access to treatment, reducing the stigma attached to mental health needs, and finding appropriate treatment are the top three goals they mentioned for the coming year, along with dealing with issues like burnout, affordability, and loneliness. “I was expecting that it might drop from the top of the list of concerns, but it still has legs,” Dunsby said.

Giving Patients Choices

While virtual visits via telehealth were commonplace during the pandemic shut-down, some providers and payers are reducing their virtual presence, requiring patients to see them in a brick-and-mortar setting. Others are going all in for virtual options. Dunsby said that surveys show that patients would like the choice of both in-person and virtual care, which is the model that One Medical has invested in. “I think that at some point, having only virtual care will be limiting. As other people are only investing in virtual care, we are opening more brick-and-mortar options. The need to form a relationship with another person who will take care of your health is strengthened by in-person interactions. Much can happen virtually, but part of what is broken in the health care system is a lack of trust between it and the patient.”

The Business Group on Health survey found that most business leaders are worried about the cost of caring for people with chronic conditions, an increase in late-stage cancer cases, and disability costs related to long Covid. Much of this could be addressed with greater use of primary care providers and the wide range of services they provide. “There needs to be more visibility and awareness around primary care,” he said. “People know that they are supposed to have a primary care provider.”

As the first stop in health care, Dunsby said primary-care providers know the local specialists, and hospitals, and understand local health systems. “They don’t just look them up in a database, but they have relationships with them.” One Medical is deeply invested in creating a team approach to care that relies on those kinds of relationships. “We are moving to an environment of greater integration of health care enabled by technology. People can access it through the web, or apps, or in person. And it isn’t just your primary care doctor, but maybe a health coach or a social worker. We are developing a model that we think will demonstrate the value of this approach, and which we think will become accepted as the ideal.”

There is still a need for more primary care physicians, and Dunsby hopes that the One Medical model will allow primary care to become a more sustainable career option. The model already allows for more of the kind of work most providers enter the profession to do: time with patients rather than paperwork. They offer 30-minute appointments, compared to the industry average of only 12 minutes per patient. “With that extra time, you can work through more nuanced issues.” While that means more costs associated with primary care, the savings in urgent care, emergency room, and costs associated with untreated chronic conditions or late discovery of cancer is significant.

“Americans are dissatisfied with healthcare now,” he said. “This is the lynch pin to changing it. We need to get this piece right.”

Editor’s note: From Day One thanks our partner who sponsored this story, One Medical.

Lisa Jaffe is a freelance writer who lives in Seattle with her son and a very needy rescue dog named Ellie Bee. She enjoys reading, long walks on the beach, and trying to get better at ceramics.