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Primary care provides patients with better outcomes at lower cost

November 20, 2008

Urgent need to prevent shortages of primary care physicians

(Washington) A white paper, How is a Shortage of Primary Care Physicians Affecting the Quality and Cost of Medical Care?, released today by the American College of Physicians (ACP) documents the value of primary care by reviewing 20 years of research. An annotated bibliography based on a literature review of more than 100 studies documents the evidence to support the critical importance of primary care in providing patients with better outcomes at lower cost, and the urgency of the need to prevent shortages of primary care physicians.

"The evidence for the value of primary care is clear," said Jeffery P. Harris, MD, FACP, president of ACP. "It manifests itself in better quality of life, more productive longevity, and lower costs as a result of reduced hospitalization, improved prevention and better coordination of chronic disease care. The nation must take immediate steps to address the issues that threaten primary care's survival."

The ACP paper notes that policymakers are more likely to take the steps necessary to assure a sufficient primary care workforce if they are aware of the research on the importance of primary care to a high-performing health care system. Featuring more than 100 studies, the white paper provides an overview of current trends in the primary care physician workforce, the importance and value of primary care, and the growing demand for primary care services in the United States.

ACP calls on the federal government, large employers and other purchasers, health plans, and the medical profession itself to take immediate action to create a comprehensive national health-care workforce policy. ACP holds that the policy should:

* focus on primary care;
* adopt a patient-centered physician guided model of health care delivery to provide Americans with optimal care; and
* restructure payment policies to support the value of care provided by primary care physicians.
* provide debt relief to those pursuing careers in primary medicine.

The consequences of failing to act, the College says, will be higher costs, greater inefficiency, lower quality, more uninsured persons, and growing patient and physician dissatisfaction. Averting the collapse of primary care is the best cure for an ailing health care system, ACP says.

"The research, literature and policy all clearly demonstrate that primary care physicians deliver high-quality care, reduce mortality, provide continuity of care, and reduce health care costs," Dr. Harris concluded. "President-elect Obama and the new Congress should embrace these recommendations as they look for primary solutions to the triple challenge of improving access, improving quality and controlling costs."

In addition to this white paper, ACP is developing a new policy paper to provide a comprehensive set of recommendations to assure that the supply of primary care physicians is sufficient to meet current and future needs. Many of ACP's ideas are reflected in the Patient Access to Primary Care Act, H.R. 7192, introduced by Rep. Allison Schwartz of Pennsylvania. This bill will be reintroduced by Rep. Schwartz in the 111th Congress, and Senator Maria Cantwell of Washington is expected at that time to introduce a companion bill in the Senate. Later in 2009, ACP will release a position paper that will make recommendations on how primary care itself needs to change to meet the needs of an aging population with more chronic diseases.

American College of Physicians