Primary care is the cornerstone of a high-performing health system, uniquely positioned to lead the shift from treating illness to achieving whole-person health. By fostering trusted relationships and emphasizing prevention alongside treatment, primary care can transform outcomes for patients and communities. Whole health approaches—integrating physical, behavioral, spiritual and social dimensions—align naturally with this mission, yet systemic barriers have slowed adoption.
Rationale for Action
Reprinted with permission from NASEM. Achieving Whole Health: A New Approach for Veterans and the Nation. The National Academies Press; 2023
Despite its alignment with whole health principles, primary care remains underfunded and overburdened.1 Integrating strategies such as lifestyle and integrative medicine offers opportunities to improve population health and reduce chronic disease.2 However, widespread implementation faces challenges, including misaligned payment models, workforce training gaps and fragmented data systems.
To address challenges, the American Academy of Family Physicians (AAFP) convened the Scaling Whole Health Strategies in Primary Care Summit in November 2025, bringing together more than 50 stakeholders to identify enablers, barriers and actionable recommendations. Recent consensus reports from the National Academies of Sciences, Engineering, and Medicine (NASEM) provided common whole health definitions and frameworks as an underpinning for the summit.
The summit aimed to:
- Identify commonalities across primary care models and disciplines that incorporate whole health strategies such as lifestyle and integrative medicine, as well as advanced team-based care—whether facilitated by fee-for-service (FFS) or value-based payment.
- Identify current enablers and barriers in health care payment.
- Identify physician and care team training that implements whole health care strategies in primary care.
- Identify recommended actions to ensure primary care practices are well-equipped to fulfill their essential role in a whole health-oriented system.
The AAFP developed an action brief to synthesize the summit’s key insights and present a strategic roadmap for operationalizing these changes across the health care ecosystem. This Beyond the Beltway article summarizes the full action brief.
Barriers to Implementation and Enablers to Scalability
Summit participants identified several critical barriers, including:
- Financial misalignment: FFS dominates; value-based incentives remain insufficient.
- Workforce gaps: Training emphasizes acute care, leaving clinicians unprepared for whole health modalities.
- Practice structure limitations: Current time constraints and workflows hinder relational, team-based care.
- Cultural inertia: Change requires mindset shifts for clinicians and patients.
- Siloed initiatives: Addressing these complex challenges demands coordinated efforts, yet many organizations continue to pursue individual agendas.
- Data fragmentation: Poor interoperability limits outcome tracking.
Summit participants also identified several key enablers of whole health scalability, including:
- Workforce training: The Veterans Affairs system trained 65% of primary care teams via virtual courses;5 Carilion Clinic embeds experiential learning in its residency.
- Team well-being: Frameworks like “Meaning, Mastery and Membership” help reduce burnout.
- Redesigned care models: Hub-and-spoke structures and integration champions drive cultural change.
- Strategic billing: Time-based codes and group visits sustain whole health under current payment systems.
- Community partnerships: Co-located services and school-based programs extend care beyond clinic walls.
Summit Vision
The vision shaped by summit participants has the potential to yield significant benefits for a multitude of stakeholders across our health care ecosystem. Successfully implementing the roadmap recommendations could impact the following audiences in several important ways:
- Patients: Improved access and equity
- Clinicians: Reduced burnout and restored joy in practice
- Health systems: Lowered costs and a sustainable workforce
Roadmap of Priorities and Action Steps
The summit discussion produced the summarized recommendations below to improve practice adoption of whole health strategies in the near-, mid- and long-term using available payment mechanisms and available training/educational resources.
Key actors – Public and private payers, health systems and medical groups
| Payment and financing |
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| Act now priorities (1–3 years to impact) |
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Key actors – Health systems, medical groups/practices and medical societies
| Workforce development and training |
|---|
| Act now priority (1–3 years to impact) |
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| Mid-term priority (3–5 years to impact) |
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| Long-term priority (5–10 years to impact) |
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The AAFP’s webpage on whole health has additional tools and resources to help family physicians promote disease prevention and long-term wellness for their patients using whole health strategies, including the summit’s full action brief, pilot projects and registration information for the AAFP’s Whole Health Summit, held May 17–19, 2026, in Charlotte, North Carolina.
