Transformation that works

Let’s Talk About Developing the Primary Care Physician Workforce

Categories  |  Medical Education

 |  By Jeri Hepworth, PhD

We know that we don’t have enough primary care physicians and that insufficient numbers of medical students and residents are choosing primary care careers.  If we care about the health of populations and the unsustainable costs of healthcare, we have to change these trends quickly and increase the number of primary care physicians.  This work is so important that we mush must have a unified plan and we must make it public. Change can be fostered by a coordinated strategy that is communicated widely. To help with communication, the national Family Medicine organizations have recently created a unified statement that succinctly describes ways to increase the number of primary care physicians to care for our patients and communities: “The Four Pillars for Primary Care Physician Workforce Reform: A Blueprint for Future Activity.”

“The Four Pillars for Primary Care” provides consistent language to help all of us advocate for the changes that are needed to develop an appropriate physician workforce.  The names of the pillars are simple:  Pipeline, Process of Medical Education, Practice Transformation, and Payment Reform.   Addressing these pillars, however, is not so easy.  It requires hard work and attention to explicit and implicit culture. 

The first step is to get excellent people into the pipeline for medical education.  Next, we must support their choices of careers in primary care throughout their education, including the “hidden curriculum”.  Excellent curriculum is not sufficient if learners are exposed to disgruntled primary care physicians, so practice transformation is crucial.  Finally, culture is explicit with regards to payment of primary care physicians.  Change in payment is beginning to occur, but the most important predictor of specialty choice is the difference between primary care and specialist income. 

CIPCI’s primary commitment is to focus on two of these pillars, Process of Medical Education and Practice Transformation, but we’re still advocates for all four.  Let’s consciously use the shared language of The Four Pillars so policy makers, educators, and our patients know what is needed to create the healthiest communities.  Let’s be more vocal about the imperative of increasing our primary care physician workforce.  

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