CHARLOTTE, N.C. -- North Carolina's 2600 family physicians are outraged at this year's flu vaccine distribution, which they say is favoring large retailers over primary care providers.

Doctors are having to send patients to grocery stores for the shot.

"Basically, large retailers with buying power have gotten their shots before community physicians. Individual practices both large and small have been put last in line and it's outrageous," commented Karen L. Smith, MD, a family physician from Raeford, N.C. and NCAFP president. "When a primary care physician needs to send their patients to the pharmacy to get their flu shot, something is wrong."

The North Carolina Academy of Family Physicians recently conducted a survey of its statewide membership to determine the scope of the problem. The findings: most physicians across the state have yet to receive vaccinations typically ordered in the spring of this year.

The problem is not limited to small practices. In one case, a large multi-site practice that cares for approximately 120,000 patients hadn't received their order either.

Some practices have received only partial orders. Since flu shots are ideally given in mid-to-late October for high risk groups including senior citizens, family physicians are frustrated.

"It breaks the continuity of care, causes patient record keeping issues and in some cases, more money to the patient. The healthcare delivery system becomes fragmented and patients get confused," noted Smith.

Similar problems are occurring at the national level, as well. In response to the issue, the American Academy of Family Physicians is considering a special task force to identify drivers and craft solutions. While both the Centers for Disease Control and the North Carolina Academy are stressing that there is no shortage of shots for this season, the distribution system needs to be investigated. Legislative mandates are one option.