How to empower the primary care workforce

Primary care is essential to the care of the population,^1-3 yet fewer people are accessing it due in part to an increasing shortage and maldistribution of primary care physicians.^4-5 That was the focus of an Oct. 20 virtual briefing hosted by Primary Care for America, a diverse collaboration of key partners (including the American Academy of Family Physicians) focused on educating policymakers and health policy influencers about the value of comprehensive, continuous, and coordinated primary care.

Aside from training more primary care physicians, the health care system must do two things to solve the primary care workforce crisis, said Yalda Jabbarpour, MD, director of the Robert Graham Center for Policy Studies in Primary Care, who presented at the briefing.

1. Create and pay for high-functioning teams, which can expand the capacity of primary care. (See "Taking Team-Based Care to the Next Level" and "Making a Business Case for Team-Based Care.")

2. Adopt technology to expand access and efficiencies in primary care — without adding to physician burden. Virtual visits, asynchronous care via patient portals (if team managed), and artificial intelligence show great promise in this regard.⁶

"But teams and technology take money and more investment in primary care," said Jabbarpour, citing data showing that, for every payer, investment in primary care has been too low and falling over the last decade.⁵ "Higher investment in primary care can result in practice changes such as more robust teams and better integrated technology that can expand the workforce we have."

^{1. Basu S, Phillips RS, Berkowitz SA, Landon BE, Bitton A, Phillips RL. Estimated effect on life expectancy of alleviating primary care shortages in the United States. Ann Intern Med. 2021;174(7):920-926.}

^{2. Bazemore A, Petterson S, Peterson LE, Phillips RL. More comprehensive care among family physicians is associated with lower costs and fewer hospitalizations. Ann Fam Med. 2015;13(3):206-213.}

^{3. Bazemore A, Petterson S, Peterson LE, Bruno R, Chung Y, Phillips RL. Higher primary care physician continuity is associated with lower costs and hospitalizations. Ann Fam Med. 2018;16(6):492-497.}

^{4. Ganguli I, Lee TH, Mehrotra A. Evidence and implications behind a national decline in primary care visits. J Gen Intern Med. 2019;34(10):2260-2263.}

^{5. Jabbarpour Y, Petterson S, Jetty A, Byun H. The Health of U.S. Primary Care: A Baseline Scorecard Tracking Support for High-Quality Primary Care. The Milbank Memorial Fund and The Physicians Foundation; Feb. 22, 2023.}

^{6. Lin SY, Mahone MR, Sinsky CA. Ten ways artificial intelligence will transform primary care. J Gen Intern Med. 2019;34(8):1626-1630.}

Posted on Oct. 24, 2023, by FPM Editors