Abstract
There is a great demand for primary care and outpatient services but a declining number of US medical trainees enter primary care each year. There is a mismatch between the need for care and service availability and society has hitherto exhibited a lackluster investment in the primary care infrastructure. Revitalizing primary care is crucial to value-based healthcare transformation.
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References
Bodenheimer T, Berenson RA, Rudolf P. The primary care–specialty income gap: Why it matters. Ann Intern Med. 2007;146:301–6.
AAMC Physician supply and demand through 2025: Key findings. https://www.aamc.org/download/426260/data/physiciansupplyanddemandthrough2025keyfindings.pdf. Accessed 17 Nov 2017.
HRSA Projecting the supply and demand for primary care practitioners through 2020. https://bhw.hrsa.gov/sites/default/files/bhw/nchwa/primarycarebrief.pdf. Accessed 17 Nov 2017.
Council on Graduate Medical Education Twentieth Report: Advancing primary care. December 2010. https://www.hrsa.gov/advisorycommittees/bhwadvisory/co%20gme/Reports/twentiethreport.pdf. Accessed 17 Nov 2017.
National Association of Community Health Centers (NACHC) United States Health Center fact sheet. http://www.nachc.org/wp-content/uploads/2017/03/US17.pdf#5. Accessed 17 Nov 2017.
Ebell MH. Future salary and US residency fill rate revisited. JAMA. 2008;300:1131–2.
Klink K. Incentives for physicians to pursue primary care in the ACA era. Am Med Assoc J Ethics. 2015;17:637–46.
AAMC Results of the 2014 medical school enrollment survey https://members.aamc.org/eweb/upload/Results%20of%20the%202014%20Medical%20School%20Enrollment%20Survey.pdf. Accessed 17 Nov 2017.
Dalen JE, Ryan KJ, Alpert JS. The 2017 match and the future US workforce. Am J Med. 2018;131:2–4.
Centers for Medicare and Medicaid Services. Comprehensive primary care plus https://innovation.cms.gov/initiatives/comprehensive-primary-care-plus. Accessed 3 Nov 2017.
Sessums LL, Conway PH. Saving primary care. JAMA Intern Med. 2017;117:1560–1.
Simmons School of Nursing Where Can Nurse Practitioners Work Without Physician Supervision? https://onlinenursing.simmons.edu/nursing-blog/nurse-practitioners-scope-of-practice-map/. Accessed 3 Nov 2017.
Agency for Healthcare Research and Quality The number of nurse practitioners and physician assistants practicing primary care in the United States. Primary care workforce facts and stats #2 https://www.ahrq.gov/research/findings/factsheets/primary/pcwork2/index.html. Accessed 3 Nov 2017.
American Association of Nurse Practitioners. https://www.aanp.org/press-room/press-releases/161-press-room/2014-press-releases/1675-2015-nurse-practitioner-ranks-surge-to-205-000-nearly-doubling-over-past-decade. Accessed 3 Nov 2017.
Hooker RS, Cawley JF, Everett CM. Predictive modeling the physician assistant supply: 2010–2025. Public Health Rep. 2011;126(5):708–16.
Sinsky C, Colligan L, Li L, Prgomet M, Reynolds S, Goeders L, Westbrook J, Tutty M, Blike G. Allocation of physician time in ambulatory practice: a time and motion study in 4 specialties. Ann Intern Med. 2016;165:753–60.
Taylor LA, Coyle CE, Ndumele C, et al. Leveraging the social determinants of health: what works? Boston, MA: Blue Cross Blue Shield of Massachusetts Foundation; 2015. http://bluecrossfoundation.org/sites/default/files/download/publication/Social_Equity_Report_Final.pdf. Accessed 17 Nov 2017.
Improving primary care. Strategies and tools for a better practice Bodenheimer, Thomas, Grumbach, Kevin (UCSF Primary Care). New York: McGraw-Hill; 2007. ISBN paperback 9780071447386.
Doran GT. There's a S.M.A.R.T. Way to write management's goals and objectives. Management review. AMA Forum. 1981;70(11):35–6.
Erikson SM, Rockwern B, Koltov M, McLean RM, for the medical practice in quality committee of the American College of physicians. Putting patients first by reducing administrative tasks and healthcare: A position paper of the American College of physicians. Ann Intern Med. 2017;166:659–61.
Berman M, Fenaughty A. Technology and managed care: patient benefits of telemedicine in a rural health care network. Health EconHealth Econ. 2005;14:559–73.
Hailey D, Roine R, Ohinmaa A. Systematic review of evidence for the benefits of telemedicine. J Telemed Telecare. 2002;8(suppl 1):1–30.
Lyles C. Seeing the effect of health care delivery innovation in the safety net. JAMA Intern Med. 2017;177:649–50.
Phelan S, Hagobian T, Brannen A, Hatley KE, Schaffner A, Munoz-Christian K, Tate DF. Effect of an Internet—based program on weight loss for low–income postpartum women. A randomized clinical trial. JAMA. 2017;317:2381–91.
Chen C, Petterson S, Phillips RL, Mullan F, Bazemore A, O’Donnell SD. Toward graduate medical education (GME) accountability: measuring the outcomes of GME institutions. Acad MedAcad Med. 2013;88:1267–80.
Baron RB. Can we achieve Public accountability for graduate medical education outcomes? Acad Med. 2013;88:1199–201.
American College of Physicians. Policy paper. 2011. Aligning GME policy with the Nation’s health care workforce needs. Https://www.acponline.org/system/files/documents/advocacy/current_policy_papers/assets/gme_policy.pdf. Accessed 17 Nov 2017.
Starfield B, Shi L, Macinko J. Contribution of primary care to health systems and health. Milbank Q. 2005;83:457–502.
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Powers, J.S. (2018). The Primary Care Dilemma. In: Value Driven Healthcare and Geriatric Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-77057-4_7
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DOI: https://doi.org/10.1007/978-3-319-77057-4_7
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