Physicians, the Affordable Care Act, and Primary Care: Disruptive Change or Business as Usual?

• Published in: Journal of general internal medicine : JGIM 2011-08, Vol.26 (8), p.934-937
• Main Authors: Jacobson, Peter D., Jazowski, Shelley A.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Delivery of Health Care - economics; Delivery of Health Care - legislation & jurisprudence; Delivery of Health Care - trends; General aspects; Health insurance; Health participants; Humans; Internal Medicine; Medical sciences; Medicine; Medicine & Public Health; Miscellaneous; Organizational Innovation - economics; Patient Protection & Affordable Care Act 2010-US; Patient Protection and Affordable Care Act - economics; Patient Protection and Affordable Care Act - legislation & jurisprudence; Patient Protection and Affordable Care Act - trends; Perspectives; Physician patient relationships; Physicians - economics; Physicians - legislation & jurisprudence; Physicians - trends; Primary care; Primary Health Care - economics; Primary Health Care - legislation & jurisprudence; Primary Health Care - trends; Public health. Hygiene; Public health. Hygiene-occupational medicine; United States
• ISSN: 0884-8734; 1525-1497
• DOI: 10.1007/s11606-011-1695-8

The Patient Protection and Affordable Care Act 1 (ACA) presages disruptive change in primary care delivery. With expanded access to primary care for millions of new patients, physicians and policymakers face increased pressure to solve the perennial shortage of primary care practitioners. Despite the controversy surrounding its enactment, the ACA should motivate organized medicine to take the lead in shaping new strategies for meeting the nation’s primary care needs. In this commentary, we argue that physicians should take the lead in developing policies to address the primary care shortage. First, physicians and medical professional organizations should abandon their long-standing opposition to non-physician practitioners (NPPs) as primary care providers. Second, physicians should re-imagine how primary care is delivered, including shifting routine care to NPPs while retaining responsibility for complex patients and oversight of the new primary care arrangements. Third, the ACA’s focus on wellness and prevention creates opportunities for physicians to integrate population health into primary care practice.