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.

Apr 01, 2022 Issue
Primary Care, Public Health, and Social Assets Are Essential to the COVID-19 Response
The COVID-19 pandemic has underscored the need for a more effective and equitable health care system in the United States. County-level variations in COVID-19 positivity rates, hospitalizations, and number of deaths demonstrate that community-level factors are essential to the pandemic response. Greater access to primary care has historically resulted in better health outcomes. Public health measures, such as masking and vaccination, and social assets, including access to housing for quarantine periods and transportation for treatment, are also important determinants of COVID-19 outcomes.

Feb 01, 2022 Issue
The National Health Service Corps at 50 Years
The National Health Service Corps (NHSC) was established in 1970 to address the mal-distribution of physicians in the United States. In 1972, it placed the first clinicians (181 physicians) into rural and urban underserved communities. Since then, the NHSC has grown into a multidisciplinary and racially diverse workforce of 16,000 active clinicians. Despite the program's clear benefits to the primary care workforce and health of vulnerable communities, budgetary constraints limit its reach.

Dec 01, 2021 Issue
Family Physicians Continue to Offer the Most Comprehensive Care
Comprehensiveness of care is one of the cardinal attributes of high-performing primary care. Evidence has shown that more comprehensive care, as measured by the number of services offered, is associated with lower costs and a reduction in hospitalizations. Comprehensiveness of care may be defined as either breadth or depth of services offered, but a comprehensive physician can take care of most of their patients' health care needs.

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.

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