Crisis in Primary Care: Physician Shortage & Underfunding Issues
TL/DR –
A new report shows that a lack of investment in primary care is contributing to stagnant or declining life expectancy in the US and health disparities in primary and preventive care. The 2024 scorecard report, published by the Milbank Memorial Fund, The Physicians Foundation, and the American Academy of Family Physicians’ Robert Graham Center, indicates that delays in accessing primary care physicians or pediatricians can lead to worsening conditions and rising costs. The report calls for more funding to train primary care clinicians and identifies five main concerns: the primary care workforce not growing fast enough; too few trainees entering primary care; underinvestment in primary care; burdensome technology in primary care; and a lack of research into novel care delivery and payment models.
Investment in Primary Care Impacts US Life Expectancy
The lack of investment in primary care has led to a stagnation or decrease in the average life expectancy of Americans, according to a recent report. This underfunding has also contributed to disparities in preventive care and overall health.
The phrase “No one can see you now” signifies extended waiting times for patients trying to schedule appointments with primary care or pediatric physicians. Such delays can exacerbate health conditions and increase medical costs.
2024 Primary Care System Scorecard
The 2024 scorecard on the U.S. primary care system, published on Feb 28, is a joint effort of the Milbank Memorial Fund, The Physicians Foundation, and the American Academy of Family Physicians’ Robert Graham Center. This follows the initial scorecard published in response to a 2021 report from the National Academies of Sciences, Engineering, and Medicine (NASEM).
The NASEM’s 2021 report called for increased funding to train primary care clinicians, including a range of medical professionals, all supervised by physicians.
Primary Care Across States
The scorecard could serve as a guide for journalists to report on primary care in individual states, suggests Yalda Jabbarpour, M.D., the study’s lead author and director of the Robert Graham Center for Policy Studies.
The scorecard provides national data on funding, access, training, and research. Some states excel while others fall behind national benchmarks. The top-performing states in key measures reported were Idaho and Alaska, with the highest percentage of the physician workforce in primary care, the report found.
Social Deprivation Index
The Robert Graham Center developed the Social Deprivation Index (SDI) to quantify disadvantage levels and assess their associations with health outcomes. This research can help identify areas requiring additional healthcare resources, according to the Graham Center.
Primary Care Accessibility Concerns
The report cites five issues affecting Americans’ access to primary care: slow growth of the primary care workforce, insufficient numbers of trainees choosing primary care, underinvestment, technology burdens, and research gaps in care delivery and payment models.
Despite primary care physicians accounting for 35% of all health care visits, they receive only about 5% of healthcare expenditures. As per the 2021 NASEM report, without more funding, the nation’s primary care systems remain weak, and the foundation is crumbling. Better investments in high-quality primary care could lead to improved health outcomes and more health equity, the report suggests.
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