Graham Center Policy One-Pagers

These reports offer succinct summaries of research and perspectives pertinent to family practice advocacy and are produced by the Robert Graham Center: Policy Studies in Family Medicine and Primary Care in Washington, DC.

Oct 01, 2021 Issue
Physician Employment Eclipses Practice Ownership: The Ongoing Trend and Its Effect on Family Medicine
In 2016, for the first time, less than one-half of practicing physicians had an ownership stake in their own practices. The most recent American Medical Association Physician Practice Benchmark Survey reveals that this trend continues. More physicians are identifying as employees instead of owners, with family physicians being the second most likely specialty to be employed. This trend has significant implications for reimbursement and practice patterns, and potential impacts on physician burnout if scope is limited by employers.

Aug 01, 2021 Issue
State-Level Variation in Primary Care Physician Density
Despite representing only one-third of the physician workforce in the United States, primary care physicians (PCPs) are the first contact with the health care system for most patients. A 2010 report by the Council on Graduate Medical Education recommended that 40% of the physician workforce be comprised of PCPs, with evidence demonstrating that optimal health outcomes are achieved with this proportion. However, the number of PCPs in the United States has been declining for decades. In addition, there are geographic disparities in the distribution of the existing physician workforce.

Jan 1, 2021 Issue
Increasing Share of Practicing Female Family Physicians, 2010-2020
The growing role of women in family medicine is increasingly apparent—more than 50% of U.S. medical students are women, and higher shares of women are entering and graduating from family medicine residency programs.

Jul 1, 2020 Issue
Family Physicians Play Key Role in Bridging the Gap in Access to Opioid Use Disorder Treatment
Buprenorphine prescribing in primary care is a key bottleneck in the access to medications for opioid use disorder (OUD). In a Medicare claims study including family medicine, internal medicine, general practice, and psychiatry, the largest share of buprenorphine prescribers were family physicians.

Jan 1, 2020 Issue
A Shrinking Primary Care Workforce in Puerto Rico
In 2018, two-thirds of primary care physicians in Puerto Rico were older than 55 years, compared with 43% nationwide. Meanwhile, only four out of every 10 graduates of family medicine residencies from 2011 to 2017 remained on the island in 2018, placing Puerto Rico’s new family physician retention rate among the lowest in the nation.

Aug 15, 2019 Issue
Proportional Erosion of the Primary Care Physician Workforce Has Continued Since 2010
We estimate that 217,208 primary care physicians provided direct patient care in the United States in 2018. This represents an even lower percentage (30%) of the total U.S. physician cohort than the 2010 Council on Graduate Medical Education's (COGME's) recommendation to increase primary care to 40% of the overall physician workforce.

Jun 15, 2019 Issue
Ensuring Primary Care Access in States with an Aging Family Physician Workforce
In many states, at least 40% of family physicians are older than 55. Therefore, policymakers should support broad training models that produce enough primary care physicians to meet state population needs.

Feb 1, 2019 Issue
Increased Quantity but Not Proportion: U.S. Medical Schools and Family Medicine Entry 2008 to 2018
Expansion in the number of American medical schools since 2005 led to an absolute increase in graduates matching into family medicine (FM) residency programs from 2008 to 2018. Proportionally, however, FM training has become increasingly reliant on osteopathic physicians and U.S. citizens trained at international medical schools (U.S. international medical graduates).

Aug 1, 2018 Issue
High Demand, Low Supply: Health Centers and the Recruitment of Family Physicians
Expansion of the Health Centers Program has been associated with persistent workforce challenges for this critical component of the primary care safety net. In a national survey, 69% of health centers had a family physician (FP) vacancy. Those with FP vacancies reported spending an average of 11.4 months recruiting for an FP, one of the longest recruiting periods for a clinical position.

Jun 15, 2017 Issue
Family Physicians Practicing High-Volume Obstetric Care Have Recently Dropped by One-Half
Previous research has shown a decline in the percentage of family physicians practicing low- or medium-volume obstetrics. Using 13 years of data through 2016, we found continued declines in low- and medium-volume obstetrics, in addition to a new 50% decrease in family physicians providing high-volume obstetrics.

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