• Tracey L Henry, Jacqueline B Britz, Joshua St Louis, Richard Bruno, OronceCarlos Irwin ACIAVeterans Affairs Advanced Health Services Research Fellowship, Greater Los Angeles VA Healthcare System, Los Angeles, California.David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California., Andrew Georgeson, Braveen Ragunanthan, Maya M Green, Neeti Doshi, and Alison N Huffstetler.
• Emory University School of Medicine, Division of General Medicine and Geriatrics, Atlanta, Georgia.
• Ann Fam Med. 2022 Mar 1; 20 (2): 175-178.

AbstractThe 2021 National Academies of Sciences, Engineering, and Medicine (NASEM) report on Implementing High-Quality Primary Care identifies 5 high-level objectives regarding payment, access, workforce development, information technology, and implementation. Nine junior primary care leaders (3 internal medicine, 3 family medicine, 3 pediatrics) invited from broad geographies, practice settings, and academic backgrounds used appreciative inquiry to identify priorities for the future of primary care. Highlighting the voices of these early career clinicians, we propose a response to the report from the perspective of early career primary care physicians. Health equity must be the foundation of the future of primary care. Because Barbara Starfield's original 4 Cs (first contact, coordination, comprehensiveness, and continuity) may not be inclusive of the needs of under-resourced communities, we promote an extension to include 5 additional Cs: convenience, cultural humility, structural competency, community engagement, and collaboration. We support the NASEM report's priorities and its focus on achieving health equity. We recommend investing in local communities and preparatory programs to stimulate diverse individuals to serve in health care. Finally, we support a blended value-based care model with risk adjustment for the social complexity of our patients.Appeared as Annals "Online First" article.© 2022 Annals of Family Medicine, Inc.

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