Publications

In May 2020, the Coalition for Physician Accountability recommended that all residency programs pivot to virtual interviews for the2020–2021 season.1This kept more than 45 000applicants from traveling cross-country during a pandemic, aiding social distancing efforts. Addition-ally, it removed travel costs, granting applicants the opportunity to assess more programs. With opportunity and human nature, however, comes the risk of an arms race, where a more open residency market compounds pressure on students to apply to more programs. The residency application process has gone down a behavioral economics rabbit hole, where fear and uncertainty are unnecessarily driving up applications, despite evidence of no benefit to applicants or programs. In what follows, we contextualize the growing problem of application inflation, describe contributing drivers including those introduced by virtual interviews, raise concerns about a conflict of interest for the application steward, and discuss potential solutions.

WASHINGTON — Ensuring access to high-quality primary care for all people in the United States will require reforming payment models, expanding telehealth services, and supporting integrated, team-based care, says a new report from the National Academies of Sciences, Engineering, and Medicine. No federal agency currently has oversight of primary care, and no dedicated research funding is available. The report recommends the U.S. Department of Health and Human Services (HHS) establish a Secretary’s Council on Primary Care and make it the accountable entity for primary care, as well as an Office of Primary Care Research at the National Institutes of Health (NIH).

Building on the recommendations of a 1996 report by the Institute of Medicine, the new report, Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care, provides an implementation plan for high-quality primary care in the U.S.

Pharmacists are more often being recognized as a critical component of the primary care team. Previous literature has not clearly made the connection to how pharmacists and comprehensive medication management (CMM) contribute to recognized foundational elements of primary care. In this reflection, we examine how the delivery of CMM both supports and aligns with Starfield’s 4 Cs of Primary Care. We illustrate how the delivery of CMM supports first contact through increased provider access, continuity through empanelment, comprehensiveness by addressing unmet medication needs, and coordination through collaborating with the primary care team and broader team. The provision of CMM addresses critical unmet medication-related needs in primary care and is aligned with the foundational elements of primary care.