Basic Health Access

Year after year various primary care associations get excited to find out the results of the match or residency choices of medical students. It is quite interesting to see how so little change is promoted so much. Even a small increase of a few dozen graduates is celebrated. Such celebrations hide the tragedy shaped by primary care payment design. This is best seen in family medicine, by far the best remaining source of primary care. Changes over time indicate the likely result of increased family medicine graduates. The increase from 2900 to 3200 seems significant at 10% growth. But over the same time period family medicine residency graduates have been choosing other career paths involving emergency care, hospitalist careers, urgent care, and other specialties. The specialty once 90% retained in primary care is down to below 70%. The impact of the actual primary care result is shown below: Annual Graduates Increase in Graduates Active in FM Positions...

Physicians and other clinicians have been moving steadily away from primary care. Specific measuring tools can indicate sources better and worse in the production of primary care. Unlike "wait and see" or projections based on annual graduates, the Standard Primary Care Year (SPCYR) is a more specific measuring tool. The SPCYR estimates the future primary care delivery at the time of graduation. Data regarding years in a career, clinical activity, and adjustments for differences in volume between primary care sources are already known.  Career Years x Primary Care Retention x Clinician Activity x Volume Adjust  =  SPCYR The career years times how that career was spent with adjustments for activity and volume differences yields the Standard Primary Career Year estimate. The most recent primary care retention figures can be inserted or the steady declines of recent decades of class years can be projected. Recent primary care retention was used rather than projec...