Reinventing Primary Care

“The nation’s system of primary care is horribly broken—the victim of underinvestment, misaligned incentives, and malign neglect…[T]he United States is already behind other developed nations in terms of its health outcomes—and today’s enfeebled system will clearly be no match for the tides of change that are about to roll in. Not the least of these will be caring for millions of Americans who, as of 2014, will newly have health insurance.” So writes Health Affairs Editor Susan Dentzer in her introduction to the influential journal’s May 2010 special edition on the status of primary care medicine in the United States.

In more than 50 articles in that issue, distinguished experts: describe components of the new health reform law and the challenges facing our primary care system; discuss the history of primary care and the problems providers now face; explore models of reform that could help the system gear up for the aging patient population; examine the medical home model as well as pay-for-performance reforms; and more.

A number of Robert Wood Johnson Foundation (RWJF) scholars, fellows, alumni and program directors contributed articles to the issue, including:

  • Joel Howell, M.D., Ph.D., an alumnus of the Generalist Physician Faculty Scholars program and a 1996 recipient of the Robert Wood Johnson Investigator Awards in Health Policy Research, on the history and background of primary care;
  • John Wasson, M.D., an alumnus of the RWJF Clinical Scholars program, on past efforts to reform primary care and how they inform current reform efforts focused on medical homes.
  • Mary D. Naylor, Ph.D., F.A.A.N., R.N., program director of the Interdisciplinary Nursing Quality Research Initiative, about the role of nurse practitioners in reinventing primary care;
  • Kavita Patel, M.D., M.S.H.S., an alumna of the RWJF Clinical Scholars program, on how to drive quality improvement and cost savings through adoption of medical homes;
  • Kevin Grumbach, M.D., an alumnus of the Generalist Physician Faculty Scholars program, joining U.S. Sen. Kay Hagan of North Carolina in describing the multi-stakeholder push to reshape health care on a stronger foundation of primary care; and
  • Robert Berenson, M.D., an alumnus of the RWJF Clinical Scholars program, on the critical need to primary care physicians to care for older people with chronic illnesses.