Publications

In most of the U.S., primary care is in deep crisis. Family physicians are reporting high levels of stress and burnout, thanks to a reimbursement treadmill that requires many of them to see four patients every hour in order to make a living. Older physicians are retiring prematurely. Heavily indebted medical students are shying away from family medicine and pediatrics, which pay less than half the $500,000-plus salaries offered to surgeons, cardiologists, and other specialists. When surveyed, few newly minted doctors express interest in joining community-based practices, preferring the set salaries that come through employment with large institutions.

COVID-19 altered the way the American public lived their lives; the way they worked, ate, socialized, traveled, and ultimately received their health care. Family Medicine largely closed its doors to face-to-face preventive and chronic care visits and made a large shift to telephone and online video visits. Ten days after the World Health Organization pronounced that the COVID-19 outbreak was a global pandemic, Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma announced that CMS was granting exceptions from reporting requirements, “so the health care delivery system can direct its time and resources toward caring for patients.”15 Suddenly quality reporting requirements were optional, and clinicians who did not submit data would not be penalized, but instead receive neutral payment adjustments. This pause led the ABFM to ask, if current clinical quality measures are not valuable in a pandemic, what does that tell us about what we are measuring?