VCU Family Medicine Professor, Rebecca Etz, PhD, and her team at the Larry A. Green Center had an article published in NEJM Catalyst | Innovations in Care Delivery in June 2023.  The article, titled “Primary Care in Peril: How Clinicians View the Problems and Solutions,” highlights findings from the Center’s Quick COVID-19 Primary Care Survey.  Conducted between March 2020 and March 2022 on a weekly then a monthly basis, each 3-5 minute survey focused on primary care clinicians and their capacity and response to COVID-19.  Approximately 8,100 unique respondents, from all 50 states and Washington, D.C., gave 32,817 survey responses, and each subsequent survey drew on information gathered in previous iterations. 

The team identified the respondents’ four areas of concern by analyzing over 50,000 open-ended comments. “Combining these four tiers of concerns - individual, practice, organizational, and national - suggests the need for both emergency and urgent responses to the panoply of issues raised by primary care clinicians on work life, mental health, and patient care quality and access.”

In response to these concerns, the team proposes two phases of reform: “emergency actions that need to be done as quickly as possible to stabilize primary care and urgent actions that need to be implemented within the next 6 to 12 months to ensure primary care's future existence.” 

Emergency reforms proposed include establishing a federal primary care emergency fund to support practices so they can maintain access, particularly in underserved areas, and addressing the mental health crisis for patients and primary care providers alike.

Urgent reforms proposed include improvements to providers’ work lives to prevent burnout, a renewed focus on interprofessional teams within the patient care realm, and offering financial incentives for future providers to choose careers in primary care to strengthen the workforce to meet the needs of communities, particularly those in rural and urban areas.

This publication was the winner of the 2023 Advanced Primary Care Practice Award, sponsored by the American Board of Family Medicine and American Board in Internal Medicine Foundation.