Posted on 01.08.10 by Jay W. Lee, MD, MPH

One of my professional roles is to facilitate a better understanding among our family medicine residents about the effects that health policies may have proximally on our ability to deliver care for patients distally.  To that end, I have developed a curriculum that touches on important arenas in health policy for clinicians ranging from social determinants of health, to history of health care reform, to stakeholder analysis of health care in the United States.  Last month, we began a health policy journal club that used two articles from Health Affairs (http://www.healthaffairs.org/) as a platform for discussing rising health care costs and how to "bend the cost curve."  One of the articles specifically looked at whether having more primary care physicians would cut health spending growth: http://bit.ly/4O1GqQ.

Their conclusion is that, though increasing the percentage of primary care physicians would bend the cost curve some, it would not be enough to do so sufficiently to address spending growth.  Should that stop us from trying to increase the percentage of primary care physicians?  Absolutely not.  What it suggests is we should be trying harder to demonstrate our value to the US health care system.  As family physicians we know our value, but does your average American know, and more importantly from a policy standpoint, does your elected representative know?

Various obstacles lie ahead of us to achieving an ideal percentage of primary care physicians in the physician workforce (at least 50 percent in my humble opinion).  Let me highlight three of the most critical:

1. How we prepare medical students for physician-hood;
2. How we pay physicians; and
3. How for-profit has undermined for-patient medicine. 

Over the next several blogposts, I will analyze these obstacles in detail and suggest potential policy solutions.  Meanwhile, if you have suggestions for future topics that you would like to see featured in this legislative blog, please comment below.