Publications

Medicine’s increasing corporatization has fundamentally altered how physicians practice, yet discussions of medical professionalism often remain anchored in frameworks from decades past. The surge in health care consolidation and sixfold growth in private equity ownership of practices has transformed physicians’ daily operations and decision-making. Any meaningful discussion of professionalism must now address these material and environmental contexts. How does consolidation affect professional daily decisions?

In the setting of the growing need to train more family physicians and the growth of available residency slots, there is also increasing concern about the decreasing percentage of family medicine (FM) residency positions being filled in the primary Match process and the increased reliance on the Supplemental Offer and Acceptance Program (SOAP) to fill residency positions.^1,2 The American Academy of Family Physicians announced in April 2025 their Residency Selection Improvement Initiative to evaluate residency selection and recruitment in FM with one of the goals being to improve the efficiency and function of the FM residency selection process.³ One of the tools identified for evaluation are the Association of American Medical Colleges (AAMC) Electronic Residency Application Service (ERAS) program signals and geographic preferences.⁴ These ERAS tools were created as an aid for applicants to highlight their interests and preferences and for programs to more easily identify interested applicants who are best suited for their program as part of a holistic application review. After being piloted by several other specialties, FM adopted program signaling where applicants could use up to five signals of interest to specific programs and signal geographic preferences in the 2023-2024 cycle.

It’s no secret that trust in healthcare is a major concern for Black patients. According to data compiled over the past four years through MHQP’s annual statewide Patient Experience Survey, there is a significant disparity in trust between Black and White patients in primary care in Massachusetts. Although trust is the foundation of high-quality healthcare, there is a dearth of research on this subject. Primary care holds a pivotal role in establishing trust, ultimately contributing to enhanced health outcomes and the mitigation of health disparities.

To help direct future research in this area, MHQP partnered with the American Board of Family Medicine (ABFM), Boston Medical Center (BMC), and the Boston Public Health Commission (BPHC) in a project funded through a Patient-Centered Outcomes Research Institute (PCORI) Eugene Washington PCORI Engagement Award (EASCS #35226).* The primary output of this effort is a Roadmap for identifying the best methods to research and reduce medical mistrust among Black patients in primary care.