Primary Care in Peril: How Clinicians View the Problems and Solutions

Abstract

Summary Primary care clinicians came under great pressure during the Covid-19 pandemic, exacerbating a long-standing crisis in U.S. primary care. In March 2020, the Larry A. Green Center for the Advancement of Primary Health Care for the Public Good launched a survey series of primary care physicians, nurse practitioners, physician assistants/associates, and other specialists. Analyzing both quantitative and open-ended responses over 2 years of the survey, which drew 32,817 responses from 8,100 respondents in every state, the authors report on clinicians’ concerns and propose a sweeping package of policy reforms to strengthen U.S. primary care practice. The findings showed severe staff shortages, financial stress, difficulty providing accessible care, challenges in sustaining telehealth, and mental exhaustion due to the growing patient burdens in mental health, untreated chronic disease, and acute care delays. These data support the 2021 recommendations on primary care by the National Academies of Sciences, Engineering, and Medicine, including expansion of population-based payment models. The authors also recommend immediate establishment of a Federal Emergency Primary Care Support Fund.