MINNEAPOLIS, December 1, 2008—Limited access to primary care doctors leads to worse health outcomes and higher costs, according to an American College of Physicians report aimed at influencing the national health system reform debate now underway. 

An American Medical News article on the report says that as the population ages and demands on health services increase, Americans will find it more difficult to locate primary care physicians to help coordinate care in a fragmented system.

The 63-page ACP white paper reviews more than 100 studies from the last 20 years and concludes that the proportion of primary care doctors in a community is related to population health outcomes and system costs. The number of U.S. medical graduates entering residences in family medicine and internal medicine has dropped by half in the last decade as physicians pursue less time-squeezed and higher-paying specialties, the ACP report said.

The ACP and groups representing family physicians and pediatricians have called for policies that encourage the patient-centered medical home, restructure primary care physician payment and help primary care doctors with medical school debt.

In November, the AMA adopted policy supporting programs to decrease the educational debt load of physicians who choose primary care practice. The Association also endorsed the medical home concept and pledged to work with medical schools to devise innovative ways to recruit and train primary care physicians.

In September, Rep. Allyson Y. Schwartz (D, Pa.) introduced the Patient Access to Primary Care Act to require Medicare to cover practices qualified as patient-centered medical homes, hike pay for evaluation and management services, and offer assistance with medical school debt.

The bill does not have a price tag yet, but Schwartz said bolstering primary care will save money over time.

Schwartz will reintroduce her bill in January. Sen. Maria Cantwell (D, Wash.) is likely to introduce a companion bill, the ACP said.

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