4 Pillars to Grow the Primary Care Workforce

Demand for healthcare is set to grow, thanks in part to the new insurance exchanges, Medicaid expansion and aging baby boomers. As demand grows, so does the strain on the already limited number of primary care physicians.

To combat the primary care physician shortage, several family medicine organizations — such as the Council of Academic Family Medicine, the American Academy of Family Physicians, the American Board of Family Medicine and the AAFP Foundation — have adopted what they call the "Four Pillars for Primary Care Physician Workforce."

They call the model "a succinct model to identify necessary conditions to ensure the needed growth in the number of primary care physicians," according to a report in the Annals of Family Medicine.

Below are more details on the four pillars, as described in the report.

1. Pipeline. To have the ranks of primary care physicians grow, the pipeline of physicians must expand through recruiting and sustaining students who will likely become primary care physicians. There are three key ways to do so mentioned in the report:
    • When potential physicians are in elementary, high school and college, begin exposing them to primary care physician role models.
    • Expand primary care physician participation on medical school admissions committees.
    • Improve outreach and mentoring programs for primary care physician students.

2. Process of medical education. One major problem students may encounter in medical school is badmouthing of the primary care profession. Students who attend schools where many disparaging comments on primary care occur are less likely to choose to practice primary care. "This highlights the need for increased leadership skills for family medicine educators within medical schools…in senior leadership positions where they can help address culture and enhance professional support," the report states.

3. Practice transformation. "The patient-centered medical home model of care provides the framework for primary care practices of the future," according to the report, and learners should be a part of interprofessional practice teams.

4. Payment reform. There are several aspects of how physicians are paid that could be changed to promote primary care. For instance, medical school debt should be addressed, as well as the gap in pay between primary care physicians and specialists.

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