Report highlights primary care’s crucial role in mitigating chronic disease 

I don’t have to tell you that, as a family physician, you’re doing the most with what you have. And the research I’ve shared over the past three winters, in a series of primary care scorecards, has illustrated that what you have—what the nation invests in its health—is not enough.  

I do want to tell you how much good your “most” is doing, a plain truth backed up by new research. 

Family physicians are key to chronic disease strategy 

The Robert Graham Center’s (RGC) 2026 report on the state of primary care powerfully quantifies the ways in which your work is making a significant dent in the U.S. crisis of chronic illness.

Specifically, we quantify that adults who have a primary care physician are more likely than adults who don’t have one to get screened for the causes of cardiovascular disease, get their blood pressure taken, get counseling on smoking cessation and receive essential cancer screenings. 

For children, we also showed that if you have a primary care doctor, you are more likely to get the preventive counseling vital to preventing injury and the major causes of childhood morbidity and mortality, including obesity and lung disease.  

The adult-child distinction is important because family physicians are the primary care specialists who treat both patient populations. Across both groups, even those who do end up developing chronic disease are less likely to need emergency or hospital care.

How family physicians can use RGC research 

This report is also valuable to AAFP members. 

First, our research in this report is essential to the advocacy work that we do for you. The Academy’s Government Relations team needs to arrive at the table with data to make the best, most current case for primary care. That’s one of the ways we use these annual reports. 

You can use this at the practice level, too. 

We know that our members feel localized, specific impacts from the underinvestment in primary care. I work for a large health system myself. I know what happens when you go to your CFO to say you need more people on staff. We hear that primary care doesn’t bring in enough money to allow additional hiring.  

No, it doesn’t attract the kind of upfront revenue showcased in quarterly reports. But we know that a robust primary care system prevents repeat emergency and urgent care visits and lowers the rate of avoidable hospitalization. That amounts to substantial savings and should appeal to the many large health systems that are increasingly exposed to downside risk. 

With value-based and risk-based contracts on the rise, health systems want to keep their patients healthy. It’s increasingly not about patient volume. It’s about outcomes. This report shows that when you back primary care, you prevent late-stage cancer diagnosis, prevent diabetes, control hypertension, keep people out of ERs and hospitals. Those things matter to health systems and payers, none of which wants to be seen as full of unhealthy people or patients who fail to improve.  

So what the RGC is doing with this report, this series, is to help individual members make the case where they are that the return on primary care investment is huge. 

Trust, relationships and preventive care versus chronic disease 

Cancer screening decisions are rarely just about guidelines. As physicians, we’re asking patients to take time off work to undergo uncomfortable, sometimes invasive tests that come with the possibility of frightening results. That’s not a purely clinical decision; it’s a deeply human one. In my experience, patients don’t agree to a screening because they’ve read the evidence; they agree because they trust the person recommending it. Trust allows patients to believe that a screening test is truly necessary for them, that the benefits outweigh the risks and that their clinician will be there if the results are abnormal. 

That trust matters even more because screening is not a single event, but a process. A mammogram may lead to a callback. A stool test may lead to a colonoscopy. Abnormal results almost always bring anxiety and uncertainty. Patients who trust their primary care clinician are far more likely to stay engaged through those next steps rather than disengaging when things get scary or complicated. 

This is why continuity in primary care is critical to improving cancer screening rates. Screening works best not when patients see a doctor, but when they see their doctor, whom they trust. Strong primary care relationships are what make that trust possible. 

Our research shows what can be done against chronic disease if policies encourage more primary care relationships like that. 

Yalda Jabbarpour, MD, is a family physician in Washington, DC, and vice president and director of the Robert Graham Center.