Publications

The Center exists in part to create original evidence and information that support and advance conversations around professionalism, value, and other health care issues.

READ about scientific publications, briefs, and reports emerging from the Center and its collaborators below.

Comprehensiveness Revisited for Next-Generation Family Medicine

Andrew Bazemore

Submitted on: August, 2026

Comprehensiveness has long stood as the beating heart of family medicine, perhaps the most distinctive feature of the discipline, and the most empirically linked to lower costs, improved outcomes, and greater equity. Barbara Starfield famously argued that comprehensiveness is “the most powerful of the 4Cs”—1^st Contact, Continuity, Coordination, and Comprehensiveness—that she declared responsible for the salutary effects of primary care and family medicine. Evidence since her seminal work has both operationalized comprehensiveness as measurable and reaffirmed its importance to achieving crucial population and policy outcomes. Yet in 2025, family medicine finds itself at an inflection point.

Changes in the Composition and Affiliation of the US Primary Care Workforce and Ownership of Primary Care Clinical Sites, 2020–2023

Submitted on: August, 2026

The US PC landscape is increasingly dominated by health systems and large corporations, with these organizations accounting for all the growth in the physician workforce between 2020 and 2023. Despite a growing workforce, the reduction in PC sites, particularly in rural areas, may negatively impact PC access. These findings suggest the need for an accessible data source for monitoring the effects of policies intended to increase the PC workforce and examining how patterns of PC site ownership affect healthcare costs and quality.

Pajama time and burnout: the burden of after-hours electronic health record use on family medicine residents

Wendy B. Barr, MD

Submitted on: March, 2026

Working on the electronic health record (EHR) after usual clinic hours (pajama time) is associated with burnout and decreased professional satisfaction in attending physicians. This study examines the association between resident pajama time and burnout, professional satisfaction, and medical knowledge among family medicine (FM) residents.