Basic Health Access

One Million Hearts Saved or 160 Million Lives Improved Part I: Limitations of Awareness It is not a bad idea to battle against preventable illnesses and deaths. Million Hearts is a campaign designed by top federal and health care experts with the goals of changing people behavior and physician behavior. These behaviors are focused on an increase in the use of aspirin and a decrease in smoking, a decrease in blood pressure, a decrease in cholesterol, a decrease in salt intake, and a decrease in transfat. When a nation goes to battle, it must know its enemies, the limits of its methods, the strengths of the enemy, the false assumptions that you will make, and the weakness of your own leadership – glaringly apparent in the first months or years of any war. "It is said that if you know your enemies and know yourself, you will not be imperiled in a hundred battles; if you do not know your enemies but do know yourself, you will win one and lose one; if you do not know your en...

Few studies critique primary care workforce sources - especially the popular sources promoted as primary care solutions. The public receives information via the media that is even more distorted and promotional in nature. One area to consider is experience in primary care delivery. Readers are cautioned that experience in primary care may not translate to quality for any number of reasons, but experience may be important to certain populations, workforce designers, and those in need of the most complex primary care delivery. Those most experienced in primary care contribute substantially to primary care continuity teams.  It is difficult to see how continuity is aided by primary care sources with the least experience in primary care and with the least retention within specific primary care practices.  Consistency in Primary Care Experience Patients visiting family physicians are likely to visit sources with the most primary care experience. Family medicine is ...

All primary care sources have declined in primary care per graduate and in rural primary care delivery per graduate. The rural Standard Primary Care Year contributions over the class years illustrate the declines in rural primary care delivery. The Standard Primary Care Year is multiplied by the proportion of the primary care component found in rural areas. Declines in Rural Primary Care Delivery per Primary Care Graduate Family Medicine has declined also, but other sources have had greater decreases due to substantial departures from primary care. Estimated Rural Primary Care Year per Graduate Changes By Class Year   PA NP FM IM PD MPD Average 1965 3.07 1.77 7.08 2.27 2.72 4.84 3.14 1980 3.18 1.77 6.92 1.86 2.36 3.90 3.22 1995 2.55 1.63 5.86 1.38 1.70 2.88 2.52 2010 1.21 1.03 5.12 0.39 0.90 1.63 1.31 2025 0.94 0.82 4.49 0.28 0.68 1.22 1.03 2040 0.86 0.75 4.28 0...