Comprehensive Blueprint for Primary Care Workforce Would Establish Patient-Centered, Efficient Health System

Wednesday, Jan. 22, 2014


LEAWOOD, Kan. — All U.S. allopathic family medicine education organizations have unanimously released a comprehensive plan which, fully implemented, would build and continue to reinforce a primary care physician workforce that focuses on patients’ needs, provides coordinated and cost-efficient health care, and improves access to care.

Dubbed “The Four Pillars for Primary Care Physician Workforce Reform: A Blueprint for Future Activity(,” the plan brings together all the elements needed to increase the number of medical students choosing primary care and to sustain their practices as patient-centered medical homes. It was published in the January/February Annals of Family Medicine( by the Council of Academic Family Medicine — comprising the Association of Departments of Family Medicine, the Association of Family Medicine Residency Directors, the Society of Teachers of Family Medicine and the North American Primary Care Research Group — with support from the American Academy of Family Physicians, and the American Board of Family Medicine.

The four pillars(1 page page PDF) are:

• Pipeline — identify, recruit and sustain students who are most likely to seek careers as primary care physicians, including early education with strong science and math coursework, counselors who can identify and encourage young people to consider primary care careers, and proactive efforts by medical school admissions committees to identify and advocate for applicants most likely to become primary care physicians.
• Process of medical education — develop curriculum and educational opportunities wherein students can have positive primary care clinical experiences, support federal funding of Title VII primary care professions grants, and establish strong departments of family medicine and family medicine interest groups on medical school campuses.
• Practice transformation — continue growth in transforming practices into patient-centered medical homes that enable all health professionals to work together in teams to provide high-quality and efficient health care.
• Payment reform — reduce the payment disparity between primary and subspecialist practice by valuing the comprehensive, complex diagnoses, treatments and other services provided by primary care physicians, support community-based graduate medical education training and reduction of medical student debt.

“This document describes the important roles that high school and college education, medical education, the physician community and the public and private payment sectors play in producing the physician workforce that the United States needs,” said Reid Blackwelder, MD, president of the AAFP. “A patient-centered, efficient health care system is not the responsibility of just one group of people or sector of the economy. Access to high-quality health care affects everyone, and all of us are part of the solution.”

The Four Pillars are based on multiple research studies that demonstrate the link between interest in family medicine and Title VII funding for primary care education, a strong family medicine presence on medical school campuses, and the comparative financial value between primary care physicians’ expertise and subspecialists’ procedures.

Building the primary care physician workforce is a complex and long-term proposition, according to Perry Pugno, MD, vice president for medical education at the AAFP. “This document is a way to succinctly communicate how this nation can address its need for a strong primary care workforce,” he said. “The current framework for our physician workforce is unsustainable. It’s characterized by excess cost, lack of coordination and maldistribution of resources, including doctors.”

Making the change will require an investment, but the return ultimately can save the nation, communities and individual patients billions of dollars.

“Multiple studies show that primary medical care is the foundation of health systems that meet patients’ needs and that avoid duplication or fragmentation of care,” said Blackwelder. “If we as a nation are to meet the triple aim of better care, better health and lower costs, we must have a strong primary care foundation. This document defines the path for building up that foundation.”

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Founded in 1947, the American Academy of Family Physicians represents 136,700 physicians and medical students nationwide, and it is the only medical society devoted solely to primary care.

Family physicians conduct approximately one in five of the total medical office visits in the United States per year – more than any other specialty. Family physicians provide comprehensive, evidence-based, and cost-effective care dedicated to improving the health of patients, families and communities. Family medicine’s cornerstone is an ongoing and personal patient-physician relationship where the family physician serves as the hub of each patient’s integrated care team. More Americans depend on family physicians than on any other medical specialty.

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