Journal
ANNALS OF FAMILY MEDICINE
Volume 20, Issue 2, Pages 175-178Publisher
ANNALS FAMILY MEDICINE
DOI: 10.1370/afm.2789
Keywords
primary health care; social justice; health equity; risk adjustment; workforce
Categories
Funding
- Larry A. Green Center for the Advancement of Primary Health Care for the Public Good and Virginia Commonwealth University School of Medicine
- VA Office of Academic Affiliations through the VA Advanced HSR Fellowship
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The article discusses the 5 high-level objectives outlined in the 2021 NASEM report on implementing high-quality primary care, and proposes priorities for the future of primary care based on the voices of early career clinicians. It emphasizes the importance of health equity and suggests the inclusion of 5 additional "Cs" to ensure the needs of under-resourced communities are met.
The 2021 National Academies of Sciences, Engineering, and Medicine (NASEM) report on Implementing High-Quality Primary Care identifies 5 high-level objectives regarding payment, access, workforce development, information technology, and implementation. Nine junior primary care leaders (3 internal medicine, 3 family medicine, 3 pediatrics) invited from broad geographies, practice settings, and academic backgrounds used appreciative inquiry to identify priorities for the future of primary care. Highlighting the voices of these early career clinicians, we propose a response to the report from the perspective of early career primary care physicians. Health equity must be the foundation of the future of primary care. Because Barbara Starfield's original 4 Cs (first contact, coordination, comprehensiveness, and continuity) may not be inclusive of the needs of under-resourced communities, we promote an extension to include 5 additional Cs: convenience, cultural humility, structural competency, community engagement, and collaboration. We support the NASEM report's priorities and its focus on achieving health equity. We recommend investing in local communities and preparatory programs to stimulate diverse individuals to serve in health care. Finally, we support a blended value-based care model with risk adjustment for the social complexity of our patients.
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