November 01, 2022
Primary care is a vital part of our health care system that is necessary to improve quality of care, contain health care costs, and improve the overall patient experience. Primary health care teams include physicians, physician assistants, nurse practitioners, and others who provide important services such as preventive care, diagnosing and managing acute and chronic disease, and referral to other specialists for specific needs. Primary care also serves a foundational role in expanding access to care in underserved communities and reducing health care disparities.
Primary care is one of the largest aspects of our health care system – with nearly 500 million visits to primary care physicians each year or over half of all physician visits. Investing in integrated primary care that is anchored by a robust primary care workforce across the country will have a positive impact on improved quality of care, lower costs, and better patient outcomes.
Primary Care’s Shrinking Workforce – Demand is Outpacing Supply
To create a sound health care system built on primary care, the U.S. requires a robust and skilled primary care workforce. However, we are facing a primary care workforce crisis. Our primary care system is struggling under increasing demands and expectations that were exasperated by the COVID-19 pandemic and a shrinking workforce that is experiencing a steady decline of new physicians, nurses, and physician assistants entering primary care.
There are an estimated 89 million people in this country living in health professional shortage areas (HPSAs). To eliminate HPSAs, we need to add an additional 15,500 primary care physicians in our health care system. However, we are trending in the wrong direction with a projected shortage of 17,800 to 48,000 primary care physicians by 2034 according to the Association of American Medical Colleges (AAMC).
A primary care workforce shortage will impact our ability to ensure equitable health care access for all, reduce health disparities, and detect and manage chronic disease. Primary care teams serve as the first line for prevention and detection of chronic diseases and are critical for long-term management of these chronic diseases. Alarmingly, this could result in conditions such as hypertension going undetected across the population, resulting in increased rates of heart disease, strokes, and other complications from poorly managed hypertension.
With approximately 25% of the primary care workforce over the age of 60, fewer medical graduates selecting primary care specialties and others leaving the field entirely, we must act now to strengthen our health care system by investing in and growing the primary care workforce.
What can be done?
Policymakers are integral in securing the future health workforce. There have been recent Federal efforts to address the needs of the primary care workforce, including an investment of $250 million from the Affordable Care Act’s Prevention and Public Health Fund for primary care professional training. However, more must be done, and governments at all levels must prioritize expanding and improving the primary care workforce. Some key areas of focus include:
Primary care serves as the cornerstone of the patient-physician relationship — helping to reduce health disparities, influencing patient engagement and improving health outcomes. Investing in the primary care workforce is essential for expanding access to care and improving quality of care. The time is now to make reforms that will increase workforce levels and center primary care as a central role in the health care system.