Health Equity: The Only Path Forward for Primary Care
https://www.annfammed.org/content/20/2/175
After the release of the 2021 National Academies of Sciences, Engineering, and Medicine (NASEM) report on Implementing High-Quality Primary Care, a group of early career primary care clinicians gathered to reflect on the report and its implications for the future of primary care. NASEM sees primary care as the cornerstone of a functional and equitable health care system and articulates 5 high-level objectives: payment, access, workforce development, information technology, and implementation with strategies to support survival and sustainability of primary care. Three themes emerged as common threads through each session: envisioning the 4 C’s of primary care (first contact accessibility, coordination, comprehensiveness, and continuity) through equity, equitable representation in team-based care, and equitable financing for primary care.
High-functioning primary care systems have better health outcomes, lower health care costs, increase patient satisfaction and improve health equity compared with poorly functioning systems. To achieve collaboration and health equity, we must develop a diverse and inclusive health care workforce. Health professions must prioritize educating and recruiting physicians, nurses, dentists, pharmacists, and other allied health professionals from diverse racial/ethnic, socioeconomic backgrounds, especially those underrepresented in medicine (URiM): Black, Hispanic and Latine, and Native Americans.
Medical students talk about their hesitancy to enter primary care due to high patient volume, insurance regulations, and limited remuneration. The financial ramifications of disparate primary care payments have resulted in extreme burnout. Especially in primary care,20 our under-resourced primary care systems struggle to meet patients’ needs. Payment reform is required to make sustainable changes that will reduce burnout, improve quality care, and drive workforce development.