Putting The Four Pillars For Primary Care Physician Workforce Into Practice Locally

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The America's -

Rest of World -

The United States faces a shortage of 25,000 primary care physicians (PCPs) by 2025.1 This report is a guide for departments of family medicine for developing local strategies to increase the PCP workforce, framed around the 4 pillars for reform: pipeline, process of medical education, practice transformation, and payment reform.2

First Steps

The first step is to define the PCP need for the region. Next, review the factors that influence student choice for family medicine from the Graham Center report3 and also captured on the ADFM Education Committee workforce strategies worksheet. Then for each of the 4 pillars below consider the local barriers, required resources, and potential allies/collaborators.


Pipeline strategic initiatives can be targeted to the premedical, medical school, and residency stages.


Does the department have linkages with high schools or college pre-med major programs? Do pre-medical students have opportunities to create personal relationships with PCPs in clinical settings or engage in primary care research?

Medical School

Does the medical school mission value primary care and is this reflected in admissions policies? Are there family physicians on the admissions committee? Are there negative attitudes and behaviors toward primary care? Is the department engaged with students in meaningful ways?


Are there enough graduate medical education (GME) positions for family medicine in your region? Can programs expand or can new programs open in GME-naïve hospitals? Can state or local support be garnered for expanding GME?

Process of Medical Education

Strategic initiatives for influencing the process of medical education can be targeted at medical school, community preceptor, resident, and residency levels.

Medical school

Are there strategic planning goals and measurable primary care outcomes linked to social mission content? Does the Department offer relevant and transformative clerkship experiences or teach valued fundamentals of doctoring? Do experiences engage social justice issues? Are there appealing experiences in global or underserved health? Are there scholarships to help students with educational debt?

Experience with community preceptors

Are students exposed to outstanding community preceptors? Do students develop beneficial mentoring relationships?

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