New Primary Care Collaborative Report Highlights Primary Care Physician Shortage and Potential Solutions

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Priorities highlighted in the report include investing in new care delivery models, targeting payment reform and bolstering the workforce by reducing education costs

Dec. 1, 2023 (ACP) -- The nation continues to face a primary care physician shortage, and the 2023 Primary Care Collaborative (PCC) evidence report, “Health Is Primary: Charting a Path to Equity and Sustainability,” shines new light on the shortage and the impact it is having on patient care.

Founded in 2006, the PCC is a not-for-profit multiparty organization dedicated to advancing a health care system built around primary care and the patient-centered medical home. The American College of Physicians is one of the founding members of the PCC.

“The new report details the current state of affairs regarding the primary care workforce and offers some policy solutions,” said Shari Erickson, ACP chief advocacy officer and senior vice president. “Overall, we do have a significant workforce challenge in primary care across the country: We simply do not have enough primary care physicians to care for all of the patients who are out there.”

The percent adequacy or percent of demand that the projected supply will meet in 2035 is 83 percent for internal medicine specialists, 88 percent for geriatricians and 90 percent for family practitioners, according to the report.

Moreover, the net effect of the primary care workforce inflows and outflows led to a loss of 10 clinicians per 100,000 population across the United States in 2019.

Seeking Sound Solutions

One PCC priority is to invest in new care delivery models such as the Making Care Primary Model, which prioritizes primary care as a driver of improved health outcomes.

Other initiatives target payment reform -- for example, establishing a hybrid payment option within the Medicare Shared Savings Program, an alternative payment model designed for Accountable Care Organizations. Such an option includes both traditional fee-for-service and value-based payments and could help get more rural and primary care physicians invested in value-based care.

Other suggestions for bolstering the primary care workforce include shorter undergraduate education to reduce costs and redirecting Graduate Medical Education funds to better support more primary care training sites, the PCC notes.

The PCC also held its 2023 summit in mid-November. Calling the summit “powerful,” Erickson said that patients shared stories of their relationships with their primary care doctors and explained how these relationships enhanced their lives.

“Patients are distressed, to say least, when they learn that it might be six to eight months before they can have an initial visit, if we can even take them on as a patient at all,” ACP Chair-Elect of the Board of Regents, and a practicing primary care internal medicine physician, Dr. William E. Fox said during a webinar on the release of the new report.

“The underinvestment in primary care in this country is staggering,” he added. “Our country spends a paltry 6 percent of health care dollars on primary care, which is about half of what high-performing health systems in sister countries spend.”

The percentage of adults not having a usual source of care is increasing, Fox noted, adding that he felt “excited and disheartened” by the current report. “Robust evidence is being gathered to help us understand these important workforce issues, but I am disheartened by the findings that the primary care workforce continues to dwindle despite a higher-than-ever demand,” Fox said.

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