Aligning Resources, Increasing Accountability, and Delivering a Primary Care Physician Workforce For America

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Overview

Our country currently faces a physician workforce shortage. Factors that contribute to our current challenge are numerous, and are only compounded by decades of neglect, misalignment of priorities and resources in medical education, and the inherent financial interest and competition between parties in the health care industry. 

In our history, we have yet to make an effort to establish a workforce policy that aligns human and financial resources with desired goals. Instead, we have relied on local and community economic forces to make these decisions on our behalf. 

While our current system excels at educating highly trained specialists and physician researchers, it fails to produce the number of primary care physicians Americans need and respect. 

Our nation’s graduate medical education (GME) system was established as part of Medicare in 1965. In the past 50 years, there have been very few changes to the core functions and finances of the GME system. As a result, despite spending approximately $15 billion annually on graduate medical education, the United States will require almost 52,000 additional primary care physicians by 2025.

The nation’s current shortage is driven by several factors, but there are three major reasons we need more primary care physicians:

  1. An increase in the number of people who have health insurance
  2. An increase in our population
  3. The aging of our population

The Institute of Medicine released the report, Graduate Medical Education that Meets the Nation’s Health Needs, on July 29. This long-anticipated report made several recommendations on how we, as a nation, can better leverage our investment in GME to produce a physician workforce that is more closely aligned with our population’s needs. The AAFP aims to build on the Institute of Medicine’s recommendations, and offer a set of policy recommendations to implement immediately to transition our GME system away from the legacy hospital-based system, and toward a robust community-based system that trains physicians to be well positioned to provide care to our growing and aging population. 

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