Family Medicine Welcomes Primary Care Workforce Access Improvement Act

Changing graduate medical education will improve primary care physician workforce

Thursday, December 15, 2011


LEAWOOD, Kan. — Family medicine educators and family physicians today hailed the introduction of the “Primary Care Workforce Access Improvement Act of 2011” as an important step toward ensuring that Americans have access to needed health care in the future.

The bipartisan legislation, introduced today by U.S. Reps. Cathy McMorris Rodgers, R-Wash., and Mike Thompson, D-Calif., establishes a system to test funding models that support primary care training where it is delivered. Under the pilot, a portion of graduate medical education payments would go directly to community-based primary care residency programs in a “money follows the resident” fashion. The entity would then collaborate with hospitals to provide necessary training in inpatient care.

The legislation drew strong support from the American Academy of Family Physicians, the Society of Teachers of Family Medicine, the Association of Departments of Family Medicine, the Association of Family Medicine Residency Directors and the North American Primary Care Research Group. Additionally, the bill is supported by the National Rural Health Association and WWAMI, the medical education partnership comprising Washington, Wyoming, Alaska, Montana and Idaho.

Currently, Medicare funding of graduate medical education is funneled solely through hospitals. The funding and payment formula do not substantively compensate for the costs of training in nonhospital settings, where most primary care services are provided. Primary care residents need to spend the bulk of their training in community settings where they will practice, according to Glen Stream, MD, MBI, president of the AAFP.

“This system doesn’t reflect the reality of our health care system,” said Stream. “More than 90 percent of care delivered by primary care physicians is in the community and the vast majority of patients get their care in community settings. So this is where much of the training for primary care doctors should occur.

“Funding for physician training directly influences the types of physicians we produce as a nation, and the current system doesn’t foster production of primary care physicians. That’s why this legislation is so important to Americans’ future access to the care they need.”

Jeri Hepworth, PhD, president of the Society for Teachers of Family Medicine, agreed. “This pilot temporarily shifts funding to entities whose sole mission is the education and training of primary care physicians. That means the educational focus will be on prevention, care coordination, implementation of the patient-centered medical home, and meeting the ongoing health care needs of families, as opposed to responding to acute episodes that require costly hospitalization.”

Research has consistently shown that health care systems based on primary medical care are more efficient and the patients have better outcomes. However, primary care physicians account for only 32 percent of all doctors in the United States, compared to the more than 40 percent recommended by researchers. Although medical student interest in family medicine has seen a modest growth in recent years, the U.S. graduate medical education system must dramatically increase the number of new family physicians to meet the burgeoning demand for their expertise and replace the aging and retiring primary care workforce.

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Founded in 1947, the AAFP represents 136,700 physicians and medical students nationwide. It is the largest medical society devoted solely to primary care. Family physicians conduct approximately one in five office visits -- that’s 192 million visits annually or 48 percent more than the next most visited medical specialty. Today, family physicians provide more care for America’s underserved and rural populations than any other medical specialty. Family medicine’s cornerstone is an ongoing, personal patient-physician relationship focused on integrated care.  To learn more about the specialty of family medicine, the AAFP's positions on issues and clinical care, and for downloadable multi-media highlighting family medicine, visit For information about health care, health conditions and wellness, please visit the AAFP’s award-winning consumer website,