Policymakers charged with growing a strong U.S. primary care workforce need to refocus their efforts on training physicians willing and able to meet changing population needs.
That's the gist of a new one-page report recently released by the AAFP's Robert Graham Center for Policy Studies in Family Medicine and Primary Care. The report, "Historic Growth Rates Vary Widely Across the Primary Care Physician Disciplines," appears in the October issue of American Family Physician.
Graham Center researchers note that the physician-to-population ratio among all primary care physicians -- family physicians, general internists and general pediatricians -- has increased steadily since 1980. However, "the general pediatrician-to-target population ratio has increased more and at a steeper rate" when compared to that of family physicians or internists, even though the country continues to experience a declining annual birth rate.
Researchers point out that millions more adults, many living in medically underserved areas of the country, soon will be seeking health care because of increased insurance coverage provided by the Patient Protection and Affordable Care Act. However, "the aging population, declining medical student interest in primary care and increased interest in hospitalist careers portend a likely crisis for the adult primary care workforce to provide accessible comprehensive care to those in need," write the authors.
According to an Oct. 18 press release from the Graham Center(www.graham-center.org), the smallest growth among the three primary care specialties was in family medicine, and yet, family physicians are the most likely to stay in primary care and practice in underserved areas.
Still, noting that the data point to select shortages among a growing overall number of physicians, the question that arises is whether medical education policy should encourage a wholesale increase in residency training positions across all specialties and subspecialties or establish incentives for educators and students to build the primary care physician workforce, said Graham Center director and study co-author Andrew Bazemore, M.D., M.P.H., in the release.
Research co-author Larry Green, M.D., said in the release that simply increasing the number of residency slots nationwide does not address the issue of patient access to care. "We need to redirect policy questions from 'How do we get more physicians?' to 'How do we get the physicians we have to go work in the right places, doing the right things for all American communities?'" said Green.
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