This is not rocket science. Only answer number 3 matters. Finances Fail all training types, expansions, and innovative models. All of the above is an incorrect answer.
Finances fail at every decision point from considering health careers to remaining in primary care after entry. This is especially true where most needed to serve 40 % of the American people where concentrations of the worst public and private health insurance plans fix deficits of workforce and access in concrete.
Financial failure has caused expansions of graduates at unprecedented rates. NP PA and DO increase at 6% more annual graduates a year - but basic health access worsens. There is a 250 billion limit on what workforce and delivery team members can be supported. Budgets are suffering reduced payments, higher costs of delivery, and new costs of delivery are added.
Financial failure sends delivery team members away from primary care. This has shaped the fewest and least experienced team members in our history. Faster expansion only makes this worse with so many more turned out with low or no experience.
Technology fails Finances as budgets are diverted away from what matters most - more and better delivery team members. Technology plus micromanagement fades delivery team members with more multitasking and overload and turnover and burnout and worse.
Primary care research fails because it is funded to prove quality improvement. Quality improvement is diverting the main sources of research funding. Outcomes are about patients, social drivers, and non-delivery factors beyond what team members can change.
Social determinant understanding should result in termination of quality improvement. Instead we have metastases that can marginalize social determinants and outcomes, just like the last 30 years of micromanagement focus.
If you do not focus on most Americans most behind and what remains of their care, you do not deserve respect as a leader in America.
We fail to have progress in basic health access because we still promote training erroneously as a solution and we still tolerate quality improvement bandwagons.
My best learning about solutions was rural practice and working with a rural managed care effort in Nebraska. They were protecting their patient base, efficiently training their team members, participated in group purchasing, met with local business benefit managers, sought new sources of funding, and worked hard for years to develop their design that now helps basic health access in multiple states.
Is it fair to MD DO NP or PA graduates to push them into areas that our nation does not support?
You must focus on finances. You must stop distractions. You must not allow payers to add more costly and disabling micromanagement.
This is it. We are losing doctors and nurses and NP and PA and others from health care entirely and from basic health access specifically.
Investing in primary care means investing in patients, communities, and the health of our nation. A new scorecard from the Robert Graham Center, with support from the Milbank Memorial Fund and The Physicians Foundation, underscores why policymakers and health care stakeholders must come together to support the primary care workforce.
The scorecard, released today, found the primary care workforce is:
✅ Struggling to meet population demands.
✅ Needs more training in underserved communities.
✅ Face added burdens from EHRs and prior authorizations.
The AAFP will always advocate for policies that advance, build and strengthen the family medicine workforce. Read the full scorecard, which includes state profiles for a localized view of primary care: https://buff.ly/49OrFLz
Thank you for sharing our good news! We were honored to have Lizzy at our grand opening event.