The field of primary care continues to face mounting challenges, but there is some room for optimism, according to several experts.
In 2019, there were about 229,000 primary care physicians in the U.S., “the largest primary care physician workforce we’ve ever seen and the largest primary care physician workforce per-capita we’ve ever seen,” said Andrew Bazemore, MD, senior vice president for research and policy at the American Board of Family Practice, at an event on the state of primary care sponsored by the American Academy of Family Physicians; Bazemore cited American Medical Association (AMA) data. However, he added, primary care physicians still make up only about 30% to 31% of the country’s total physicians.
Spurred by a novel coronavirus pandemic, 2020 will undoubtedly stand out in the annals of history for radically upending the norms of US politics, economy, culture, and race relations and reminding us of the fragility of life as we know it. The US health care system, which has long struggled with fragmentation and poor return on unmatched per-capita spending, further revealed its shortcomings, among them continuing inattention to primary health care, which the world has long declared should be the “central function and main focus [of a] country’s health system.”1 The disproportionate impact of COVID-19 on disadvantaged communities has shone another bright spotlight on the long-standing health and wealth inequities in our nation and the urgent need to address them.
Primary care (PC) is an essential building block for any high quality healthcare system, and has a particularly positive impact on vulnerable patients. It contributes to the overall performance of health systems, and countries that reorient their health system towards PC are better prepared to achieve universal health coverage. Monitoring the actual performance of PC in health systems is essential health policy to support PC. However, current indicators are often too narrowly defined to account for quality of care in the complex populations with which PC deals. This article reviews a number of conceptual frameworks developed to capture PC values in robust measures and indicators that can inform policy and practice performance. Each have benefits and limitations. Further work is needed to develop meaningful primary health care (PHC) and PC measures to inform strategic action by policymakers and governments for improved overall performance of health systems.