Dec 7, 2011, 1:00 PM, Posted by Lawrence Casalino
By Lawrence Casalino, MD, PhD, Chief of the Division of Outcomes and Effectiveness Research and The Livingston Farrand Associate Professor of Public Health, Department of Public Health, Weill Cornell Medical College
Barbara A. Ormond and Randall R. Bovbjerg’s “Ensuring Access to Care Under Health Reform: The Key Role of Workforce Policy” is balanced, thoughtful, and well-written, with a carefully selected bibliography. It will be a very useful resource for people interested in primary care. The authors clearly lay out four alternative, but not mutually exclusive, approaches to improving access to primary care, present likely advantages and disadvantages of each, and list policy approaches needed for each approach to succeed.
The article is framed in terms of workforce policy and access to primary care. But it convincingly argues that these issues should not be discussed separately from issues related to re-designing primary care to provide higher quality for patients and to make a primary care career more attractive to clinicians. I agree with the main points made in the article, though there are some issues that that I think are worth emphasizing more strongly and/or elaborating: