Podcast listeners are aware US healthcare significantly underperforms. Among numerous other statistics, despite spending approximately twice what comparative countries spend on healthcare, the US has highest rates of preventable deaths. Even wealthy Americans are more likely to, for example, die during childbirth, from cancer and from heart attacks than those in 12 comparative countries. This is substantially due to the fact primary care in the US, as the National Academy of Medicine report states in its opening, is “slowly dying.” The report further notes despite the fact primary care's value is beyond dispute, approximately 25% of Americans do not have a primary care physician and 80 million Americans live, per HRSA, in primary care health professions shortage areas. In turn, this is largely due to the fact only 5% of healthcare spending goes to primary care despite such visits accounting for 40% of all medical office visits. Translation: primary care physicians are substantially undercompensated that contributes to a growing shortage of primary care clinicians.
During this 34 minute conversation, Dr. Phillips discusses several of the reports nearly 20 recommendations including recommending all Americans select a primary care provider or be assigned one and that there be created a HHS Secretary Council on Primary Care. Among other subject covered in the report, Dr. Phillips discussed Primary Care Medical Homes (PCMHs), discusses measuring quality performance, value and risk adjusment particularly as it relates to adjusting for social risk or social need.
Robert L. Phillips, Jr., MD, MSPH, is the founding Executive Director of the Center for Professionalism and Value in Health Care. Dr. Phillips also currently practices part-time in a community-based residency program in Virginia and is Professor of Family Medicine at Georgetown University and Virginia Commonwealth University. Prior to, or from 2012 to 2018, he was Vice President for Research and Policy where he led the launch of a national primary care clinical registry and a Measures that Matter research and development program for primary care. Previously still, Dr. Phillips served as Director and Assistant Director of the Robert Graham Center in Washington DC. He has also served on the American Medical Association’s Council on Medical Education and as President of the National Residency Matching Program. Dr. Phillips was elected to the National Academy of Medicine (NAM) in 2010. He currently serves NAM's Membership Committee and the Action Collaborative on Clinician Well-Being and Resilience. He is a graduate of the Missouri University of Science and Technology and the University of Florida College of Medicine where he graduated with honors for special distinction. He completed his family medicine training at the University of Missouri that was followed by a two-year fellowship in health services research and in public health.
Information regarding the report is at: https://www.nationalacademies.org/news/2021/05/high-quality-primary-care-should-be-available-to-every-individual-in-the-u-s-says-new-report-payment-reform-telehealth-expansion-state-and-federal-policy-changes-recommended.
The report is summarized in a May 4 JAMA Viewpoint essay, at: https://jamanetwork.com/journals/jama/fullarticle/2779749.
Information on the report's webinar series, noted during the interview, is at: https://www.nationalacademies.org/our-work/implementing-high-quality-primary-care.