"Because the Affordable Care Act will expand health insurance to cover an estimated thirty-two million additional people, new approaches are needed to expand the primary care workforce. One possible solution is Grand-Aides®, who are health care professionals operating under the direct supervision of nurses, and who are trained and equipped to conduct telephone consultations or make primary care home visits to patients who might otherwise be seen in emergency departments and clinics."
"The authors conducted a study in which they explored the geographical distributions of primary care dentists, physicians and pharmacists to determine if a spatial pattern existed between provider types across cities in Iowa."
"The current shortage of primary care physicians (PCPs), particularly as more individuals obtain health insurance and seek primary care services, is a growing national concern. The Crimson Care Collaborative (CCC) is a joint student–faculty initiative in post-health-care-reform Massachusetts that was started with the explicit goal of attracting medical students to primary care careers. It fills a niche for student-run clinics, providing evening access to primary care services for patients without a PCP and urgent care services for patients of a Massachusetts General Hospital–affiliated internal medicine clinic, with the aim of decreasing emergency department use in both groups."
"The health reform law boosted Medicare fees for primary care ambulatory visits by 10 percent for five years starting in 2011. Using a simulation model with real-world parameters, we evaluate the effects of a permanent 10 percent increase in these fees. Our analysis shows the fee increase would increase primary care visits by 8.8 percent, and raise the overall cost of primary care visits by 17 percent. However, these increases would yield more than a sixfold annual return in lower Medicare costs for other services—mostly inpatient and postacute care—once the full effects on treatment patterns are realized. The net result would be a drop in Medicare costs of nearly 2 percent. These findings suggest that, under reasonable assumptions, promoting primary care can help bend the Medicare cost curve."
"We compare the association between barriers to timely primary care and emergency department (ED) utilization among adults with Medicaid versus private insurance."
"As part of the Readiness for Reform initiative, the AAMC presents a case studies series to share member strategies for implementing key elements of health reform. These 10 cases showcase a series of competencies required for success from AAMC member teaching hospitals and medical schools in an era of reform. The institutions profiled are implementing diverse programs and initiatives to transform their care delivery models."
"Research demonstrates an association between the geographic concentration of primary care clinicians and mortality in the area, but there is limited evidence of a mortality benefit of primary care at the individual patient level. We examined whether patient-reported access to selected primary care attributes, including some emphasized in the medical home literature, is associated with lower individual mortality risk."
"Part I of Dr. Starfield's update of her seminal books, Primary Care: Concept, Evaluation, and Policy and Primary Care: Balancing Health Needs, Services, and Technology, comprises 6 invited lectures plus an 11-lecture course that examines the meaning, practice, and effectiveness of primary care. Topics include disease, morbidity, primary care innovations, health equities and disparities, prevention, and specialist care."
"Student perceptions of day-today physician work life, and relationships between these perceptions and specialty choices, have not been quantitatively explored. The study’s purposes were to measure student perceptions of primary care and specialist physician work life, including administrative burden, time pressures, autonomy, and relationships with patients, to determine whether senior students’ perceptions vary from junior students’ perceptions and to determine whether students with primary care career plans view primary care work life differently than their peers."
"Primary Care 2025: A Scenario Exploration is a project developed by the Institute for Alternative Futures (IAF) with support from the Kresge Foundation to consider the range of forces, challenges, and opportunities shaping primary care in the United States. Complex change comes as new technologies meet an aging society in a time of growing economic and political divides. This is not a time for reactive decisions based only on a view of past trends in health care. The inherently uncertain future of primary care in a time of great flux means that a systemic understanding of future possibilities is all the more important for informing what we do today and tomorrow."
"This fact sheet shows that primary care physicians, nurse practitioners, and physician assistants are more likely to practice in rural areas than are non-primary care specialists, but are still more concentrated in urban areas."
"How would you describe the state of family medicine 'Strong?' 'Not good?' Or perhaps 'the strongest it has ever been?' It's a complicated question involving multiple factors. This article will examine three important ones."
"The Patient-centered Medical Home (PCMH) concept, essential functions of primary care, and an appropriate primary care workforce have been shown to improve health outcomes and reduce health care costs. This paper describes a curriculum that uses the PCMH and related health policy concepts as the foundation for didactic, clinical, and self-directed elements. The PCMH-focused curriculum improved overall student clerkship ratings and maintained student performance on the National Board of Medical Education subject exam."
"As an organizer for the American Medical Student Association, I work with a national network of students passionate about health care justice, unafraid to engage in contentious battles and ready to answer the call to primary care. I appreciate the data about primary care physicians’ positive impact on the health of nations, believe that primary care is a matter of social justice, and appreciate the pivotal role primary care physicians have in caring for the underserved."
"The United States is faced with an increasing shortage of physicians in the primary care workforce. The number of medical school graduates selecting careers in primary care internal medicine has fallen dramatically since 1985. Although political, financial, and organizational reform of the medical system is necessary, these changes will address only part of the problem."
The October supplement to the American Journal of Preventive Medicine (AJPM) is titled “Patients and Populations: Public Health in Medical Education,” and is based on the September 2010 conference of the same name. Both the conference and supplement were funded through the Association of American Medical College’s cooperative agreement with the Centers for Disease Control and Prevention. The supplement describes curricular innovations and resources to help integrate public health, population health and prevention in medical school and residency curricula, and includes commentaries from leaders in public health and medicine.
"The recent Affordable Care Act (ACA) includes physician training provisions to address the US primary care workforce shortage and maldistribution. Policymakers require current graduate medical education (GME) residency finance data to design and implement programs that increase primary care physicians. The University of Washington Family Medicine Network residencies have collaborated for 10 years in collecting and comparing data regarding the revenues and expenses of their training programs. Based on biennial survey results from 2000 to 2010, this study examines changes in the finances of residency training over a decade using a standardized methodology."
"Clinica Family Health Services is a community health center serving a low-income, largely Latino population near Denver. Since its inception 30 years ago in founder Alicia Sanchez's kitchen, Clinica has grown to serve 40,000 patients at four sites. Fifty percent of these patients are uninsured; 40% have Medicaid. Like many community health centers, Clinica is financed by augmented Medicaid fees, federal grants, sliding-scale payments from uninsured patients, and energetic local fundraising."
"Over the last 50 years, medical student debt has become a problem of national importance, and obtaining medical education in the United States has become a loan-dependent, individual investment. Although this phenomenon must be understood in the general context of U.S. higher education as well as economic and social trends in late-20th-century America, the historical problem of medical student debt requires specific attention for several reasons."
"A longitudinal mentoring program can effectively support student interest in primary care if it focuses on the needs of the students and is supportive of the mentors."
