21st National Conference Plenary: Health Reform Legislation Consequences for the Nation's Primary Care Physicians

Donald Frey, MD

The second plenary session of the Twenty-first National Conference on Primary Health Care Access will be held on the morning of Monday, April 12, 2010. The session will be comprised of a roundtable discussion on what the consequences may be on the nation’s physician workforce, particularly primary care physicians. The roundtable discussants will be Doctor Donald Frey, Creighton University’s Vice President for Health Affairs, Doctor Thomas Hines of Boston University, and Doctor James Herman of the Penn State University Hershey Medical Center.

Over the past 40 years, Family Medicine and Community Health physicians have been engaged in efforts to meet perceived community and regional health care needs with only a limited mandate to do so. Over that period of time, national public policy devoted relatively little attention to the needs for effectively trained primary health care and public health workforces.

Doctor Hines will give an overview of the policy workforce issues that were raised when the State of Massachusetts enacted legislation mandating health insurance.

Thomas Hines, MD

Additionally, the discussion will note federal efforts and professional organization efforts to encourage the development of primary care physician training programs that address the needs of “underserved” rural and urban communities.With relatively little national attention and minimal funding, regional and community infrastructures for training physicians have been created over that 40 year period that will help meet the primary health workforce requirements of the new legislation.

These regional and community infrastructures include:

  • training physicians to diagnose and treat a person’s physical and behavioral health care needs.
  • training these physicians in the use of available resources – other physician specialties, tertiary care facilities, community resources.
  • creating residency programs that teach “systems of care”.
  • creating medical school departments that assume community-oriented objectives, designed to improve the health care delivery system in specific underserved communities and to provide a primary health care workforce for them.
  • by training physicians to work in community health centers and other “safety net” providers, assisting those providers in meeting their immediate and long term workforce direct patient care  (“linkage” programs that in the current legislation in Congress are called “teaching health centers”).

Subsequent to this plenary session, a series of presentations on regional primary care training activities take place.

sub