Make Primary Care a Strategic Partner in Addressing Our Most Important Health Priorities

Submitted on Tue, 03/29/2022 - 09:22

In this month’s issue of Annals of Family Medicine, Robert Phillips, MD, MSPH, addresses three responses from U.S. and Canadian primary care research groups to the 2021 National Academies of Science, Engineering, and Medicine (NASEM) report, Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care. This first report in 25 years builds upon the recommendations from the 1996 Institute of Medicine report, "Primary Care: America's Health in a New Era.”

Dr. Phillips served as the committee co-chair on the NASEM report and is the founding Executive Director of the Center for Professionalism and Value in Health Care, located in Washington, DC.  His editorial is in response to two articles in the issue linking the NASEM report to the national priority of health equity and another article which addresses the critical neglect of funding for primary care research. All three articles amplify the fact that primary care should be a common good and is essential to improving health equity in this country. Dr. Phillips reviews the issues cited by the three groups of researchers, underscoring the objectives outlined in the NASEM report, which address the many changes needed for primary care to be an effective agent for equity: payment, access, workforce development, information technology, and primary care implementation. He emphasizes the aim of the NASEM report to make primary care a strategic partner in addressing our most important health priorities.

The first paper by Tracy L. Henry, MD, et al, focuses on health equity as the foundation of the future of primary care. She and her coauthors were inspired by the NASEM report to spend several months in facilitated meetings reflecting on primary care’s roots. Their paper proposes 5 additional primary care Cs (convenience, cultural humility, structural competency, community engagement, and collaboration) to be added to Barbara Starfield’s original 4 Cs (first contact, coordination, comprehensiveness, and continuity) in order to support under-resourced communities.

A paper authored by Azza Eissa, MD and colleagues emphasizes the importance of equity-focused primary care and provides recommendations on how the profession could operationalize the recommendations described in the 2021 NASEM report through a health equity lens. The authors pull on evidence from other countries that primary care can impact health equity if supported as the NASEM report suggests.

The third paper by current and former leaders from the Agency for Healthcare Research and Quality (AHRQ), led by Arlene Bierman, MD, MS, asserts that realizing the potential of primary care will require wise investments in primary care, paralleling key points of the NASEM report. The NASEM report highlights that primary care, which provides more than one-third of all visits to the health care system, receives less than 1% of federal research funding.

Read the editorial here: Implementing High-Quality Primary Care: To What End?


Founded in 2018 by the American Board of Family Medicine and its supporting foundation, the Center for Professionalism & Value in Health Care (CPV) aims to align how the professions are valued with the values of the professions. Working with a variety of partners, CPV will help to shape both the public’s and the provider’s understanding of the social contract as well as policies that better support its success.