To raise awareness of the value of primary care and encourage their fellow lawmakers to provide greater support for those who practice it, two House members recently launched the Congressional Primary Care Caucus.
Rep. David Rouzer, R-N.C., speaks at the launch of the Congressional Primary Care Caucus as Rep. Joe Courtney, D-Conn., listens. The two are co-chairs of the caucus.
Reps. David Rouzer, R-N.C., and Joe Courtney, D-Conn., co-chairs of the caucus, gave brief welcoming remarks at the launch event last week on Capitol Hill.
"Increasing access to primary care is one of the best ways to promote better health outcomes and control costs," Courtney said in a statement. "I am looking forward to promoting health care policy that recognizes and capitalizes on the importance of primary care in underserved areas and works to strengthen our primary care workforce nationwide."
Rouzer highlighted what's at stake for the country: "We are reminded of the tens of thousands of families across our nation -- and especially in my district, which includes rural southeastern North Carolina -- that are affected by the shortage of primary care physicians."
The AAFP is throwing its support behind the caucus as one way to secure the federal support needed to expand the ranks of primary care physicians.
- In an effort to raise awareness of the value of primary care, two House members recently launched the Congressional Primary Care Caucus.
- The AAFP is supporting the caucus as one way to secure the federal support needed to expand the ranks of primary care physicians.
- Physicians at a launch event for the caucus shared stories of how primary care made big differences in patients' lives.
"The Primary Care Caucus will be instrumental in examining how to build the primary care workforce and the infrastructure that will complete the system's evolution and in recommending potential congressional action," said AAFP President Wanda Filer, M.D., M.B.A. of York, Pa.
Andrew Bazemore, M.D., director of the Robert Graham Center for Policy Studies in Family Medicine, said primary care is "grossly undervalued." For instance, he said, the huge demand for care in rural areas is borne largely by community health centers rather than academic health centers.
Hospital visits and acute care account for the highest health care costs, Bazemore said, with too little investment in the prevention that primary care offers. And he pointed out the broad scope of primary care.
"I don't have the luxury of providing care for diabetes patients just for diabetes," Bazemore said. "The complexity of the visits can't be underestimated. We need primary care now more than we ever did."
At the launch event, physicians discussed how primary care helped patients who were struggling with long-term health problems.
Robert "Chuck" Rich, M.D., a family physician in Elizabethtown, N.C., shared his experiences working in a rural private practice. He said 80 percent to 90 percent of his patients have insurance coverage either through Medicare or Medicaid. Many come to his clinic with diabetes, hypertension, heart disease, lung disease or other chronic illnesses.
"You name it, and we see it," Rich said. "I'm doing this as one provider. They're seeing me for everything."
But practicing in a rural area often means going without support such as a pharmacy, home care, behavioral health workers or adequate transportation for patients.
"That's not a criticism; it's reality," Rich said. "More resources are needed."
Rich recalled one patient, a middle-aged woman who suffers from both heart and lung disease. She made frequent visits to the ER. She told Rich that she tried not to call the emergency line but she did not have reliable transportation to his office.
When a nurse later went to her home to manage her care, the patient, who had said during previous visits that she was taking her medication, admitted that she could not afford it. Rich's practice then helped her obtain financial assistance for the medication.
Another physician at the launch event, Ramindra Walia, M.D., medical director for United Community & Family Services in Norwich, Conn., recalled a 21-year-old gas station attendant who had struggled with ongoing pain for five years. Her co-workers called her a whiner. She had visited a subspecialist and even endured exploratory surgery, only to be told that nothing was wrong with her.
Later, after speaking with a nurse who came into the gas station one day, the patient went in for X-rays, which revealed that a congenital hip deformity was causing the pain.
"At least people will believe me now," she said, and she arranged for surgery.
"All this woman needed was to be connected to a primary care doctor," Walia said.
The caucus will help these kinds of stories resonate among policymakers who wrestle with budgeting decisions for graduate medical education and rural health centers.
"Congress must have accurate information about the multiple factors affecting the primary care workforce and patients' access to services," Filer said. "Medical education funding, payment for quality of services, ensuring comprehensive and coordinated care, and meeting primary care needs of underserved Americans -- these are big issues. They require the focused attention that the Primary Care Caucus will provide."
Related AAFP News Coverage
New Caucus Forms to Champion Primary Care on Capitol Hill
Dear Colleague Letter: Join the Primary Care Caucus(1 page PDF)