One-Pager Illustrates Need for Education Policy That Builds Primary Care Physician Workforce
Senior Public Relations Strategist
American Academy of Family Physicians
(800) 274-2237, Ext. 5224
WASHINGTON — America's primary care physician workforce has grown faster than the overall population, but that doesn't mean all Americans have access to the care they need, according to a recently published one-pager in the October issue of American Family Physician.
The one-pager, "Historic Growth Rates Vary Widely Across the Primary Care Physician Disciplines," was written by researchers at the Robert Graham Center for Policy Studies in Family Medicine and Primary Care. In it, the authors point out that the number of primary care physicians — defined as family physicians, general internists, and general pediatricians — has grown over the past 40 years. However, within that growth, analysts see an imbalance: the increase in general pediatricians has far outpaced that of family medicine and general internal medicine.
"The family medicine and general internal medicine physician-to-target population ratios have shown small incremental growth, whereas the general pediatrician-to-target population ratio has increased more and at a steeper rate," the authors write in the one-pager.
The data point to select shortages within a growing overall number of doctors, according to Andrew Bazemore, MD, MPH, director of the Graham Center and co-author. Within primary care medicine, the smallest growth is among family physicians — the medical specialty most likely to stay in primary care and practice in underserved areas.
The question, then, is whether medical education policy should encourage a wholesale increase in residency training positions for any specialty or subspecialty, or establish incentives for educators and students to build the primary care physician workforce, he said.
Co-author Larry Green, MD, agreed the data demonstrate that simply increasing the number of residency training positions does not solve patient access issues. The physician shortage problem is not how many overall physicians are trained but "what these physicians are doing and where they’re going," he said. "We need to redirect policy questions from 'How do we get more physicians?' to 'How do we get the physicians we have to go work in the right places, doing the right things for all American communities.'"
Family physicians are the only medical specialty that consistently provides primary care for patients in underserved areas, according to Agency for Healthcare Resources and Quality workforce data. AHRQ reports that of the primary care health professionals who work in rural, underserved areas, some 47,000 are family physicians.
The upshot, according to Green and Bazemore, is that U.S. physician workforce policy should not focus on a wholesale, unsystematic growth in the number of physicians. Rather, efforts to grow the workforce should be targeted to best meet the needs of underserved populations.
The Robert Graham Center for Policy Studies in Primary Care and Family Medicine conducts research and analysis that brings a family practice perspective to health policy deliberations in Washington. Founded in 1999, the center is an independent research unit working under the personnel and financial policies of the American Academy of Family Physicians.
The information and opinions contained in research from the Graham Center do not necessarily reflect the views or policy of the AAFP.
October 18, 2013