Even though PC is the only component of healthcare shown to increase life expectancy and is crucial to achieving healthcare equity, outcomes, quality and value PC remains on life support. For example, an August National Academy of Medicine report concluded, “despite PC’s essential value for the health of the nation, more than 100 million people across rural and urban communities in the US are experiencing a calamitous lack of access to primary care.” Among numerous problems: PC accounts for less than 5% of total healthcare spending; there are too few primary care clinicians and too many, at 7,501, HRSA PC shortage areas; PC clinicians are inadequately reimbursed and maldistributed. Consequently, PC struggles to adequately address prevention, the social determinants of health, integrate care particularly behavioral health services and ultimately achieve optimal value. In “Wonderful and Broken,” Prof. Brennan discusses how PC care can be improved and organizations that are at least on the path toward stable and effective PC delivery. (Listeners may recall I interviewed Prof. Brennan in October 2024 regarding his just published previous work, “The Transformation of American Health Insurance” & that this is at least my 5th PC discussion dating back to 2013.)
Information on Prof Brennan’s book is found at: https://www.press.jhu.edu/books/title/54051/wonderful-and-broken?srsltid=AfmBOor4SJMCBvCYWck_6Aobdxk-ZUJgusnceOxxT-eghoU8CkPc3kMl.
