The Academy wrote in response to recent executive orders updating the federal immigration system and delivering federal student loan reprieves beneficial to many frontline health care workers — actions, the Academy said, that could lay the foundation for improvements to the primary care pipeline. In particular, the letter noted that the order preserving the Deferred Action for Childhood Arrivals program would have a positive impact on primary care.
Reminding the administration of the impending shortage of primary care physicians, the letter called for several additional policy initiatives that are also likely to help meet that need.
The White House should “work with Congress to make permanent and increase funding to expand the Teaching Health Center Graduate Medical Education program,” the letter said. Given that most family physicians practice within 100 miles of their residency programs, “the primary care physician shortage can be significantly reduced by increasing residency slots in current programs and expanding the THCGME program to all 50 states.”
Citing an AAFP position paper, the letter called the National Health Service Corps “essential to recruiting physicians who will continue practicing in rural areas long term.” The Academy praised Biden’s recommendation that the NHSC assist with the COVID-19 response in high-risk communities and recommended that it be prioritized, preserved and expanded.
The 2021 Medicare physician fee schedule’s newly implemented payment increases remain “a positive step in appropriately valuing vital primary care services” while helping to recruit and retain future family physicians, the letter said. “We urge your administration to build upon these recent Medicare changes by advancing payment policies that prioritize prevention and reward the continuous, comprehensive care that family physicians provide.”
The letter called for the reversal of three Trump administration rules affecting international medical graduates (who make up 22% of family physicians) and physicians seeking or holding visas, including
The Academy repeated to the administration its recent opposition to a Veterans Affairs interim final rule allowing non-physician clinicians to practice without appropriate physician supervision. The rule should be rescinded and reversed, the letter said, and the administration should — across all federal agencies — “support interdisciplinary, physician-led, team-based care models in the pandemic response and across the health care system.”