In 1990, a group of persons interested in family and community medicine, medical school reform, and advocacy for rural, inner city and other geographical areas of need, were invited to rural Wisconsin for the First National Conference on Primary Health Care Access. Since then, similar groups have been invited to assemble each Spring.
Periodically, landmark national legislation is enacted (Medicare and Medicaid in the mid-20th century; the Affordable Care Act in the 21st), each of which has proven to have unintended consequences that exacerbate access to care.
Over the years, many of the pioneers, key strategists, researchers and policy makers who have promoted the idea of community-responsive medical education have participated in one or more of the National Conferences. (Many have participated in twenty or more of the 27 conferences held through 2016.)
The National Conferences have continuity in the conference faculty from year to year. The conferences are limited to approximately 55 participants. Persons who enroll in the conference series are invited to renew their space in each subsequent conference.
Public Policy and Access to Primary Healthcare
Lack of access to health care is a problem in most rural, inner-city, lower socioeconomic, and minority communities. That lack of access is in part due to the decline in the numbers of general practitioners and family physicians and the increase in medical subspecialists, who typically do not locate in inner city or rural areas.
The subspecialization of medicine increased in every decade of the 20th century and continues in the 21st. That specialization appears to be accelerating, and with it the decline in percentage of primary care providers when compared with subspecialists. (Many areas continue to experience an absolute decline in numbers of primary care providers.)
Trends suggest that current levels of funding for primary care activities are inadequate for turning the tide of subspecialization, and such new resources as might be commanded are marginal.
Hopeful approaches include the encouragement of strategies for increasing the cost-effectiveness of current levels of effort and the forging of strategic linkages between health care sectors such as primary care training programs, community-based health care delivery systems and primary health care professionals specifically trained to practice in communities of chronic physician shortage.
Such strategies and such linkages are the content of the National Conferences.