In a recent commentary (K Grumbach et al. NEJM 2021; 385: 1156-8. Revitalizing the U.S. Primary Care Infrastructure), it’s clear a day of reckoning is coming due to a depletion of primary care physicians.
Scope of the problem:
- “High-quality primary care is vital but undersupported in the United States. In communities with more primary care resources, people live longer, health care costs are lower, and there is greater health equity”
- “Primary care physicians make up only 30% of the physician workforce…research on primary care garners just 1% of federal agency research awards”
- “Primary care physicians earn 30% less than other physicians, on average, and they have among the highest rates of physician burnout”
- “The situation is worsening…between 2005 and 2015, the number of primary care physicians in the United States decreased from 46.4 to 41.4 per 100,000 people, and the proportion of nurse practitioners and physician assistants who work in primary care is dropping”
- Currently, the number of physician training to become family physicians is “well below the level needed to replace retiring family physicians. Less than one in five internal medicine residency graduates pursue careers in primary care, down from half of such graduates 25 years ago”
The authors propose a government council to develop and implement a plan to address the looming crisis.
My take: Virtually nothing has been done in 25 years to address this problem and I doubt anything substantive will emerge in the near future; though, it would be good policy to incentivize more physicians to go into primary care.
Related blog posts:
- Atul Gawande: Tell Me Where It Hurts
- What is Wrong with the Glimmer of “Precision Medicine” | gutsandgrowth
- Zip Code or Genetic Code -which is more important for …
- “Issue-attention cycle” problem. “This pattern occurs when initial public alarm over the discovery of a problem and optimism about its quick resolution are replaced by the realization that solving the problem will require some public sacrifice and will displace powerful societal interests.”from Weight of the Nation | gutsandgrowth