Annals of family medicine
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Annals of family medicine · Nov 2024
Diabetes Management: A Case Study to Drive National Policy Change in Primary Care Settings.
Despite medical advances, diabetes management remains a considerable challenge in the United States, with little to no improvement in patient outcomes and stark disparities in underserved communities. One acute challenge is that, as the US population with diabetes grows steadily-numbering 38.4 million people today-there are too few endocrinologists available to treat the disease and the burdens on primary care professionals, who treat more than 90% of cases currently, are staggering. This disconnect between need and care capacity presents what may be the greatest of many threats to the care of diabetic Americans. ⋯ Policy recommendations encompass the integration of the chronic care model and the patient-centered medical home approach, expansion of workforce development initiatives, and payment reform to incentivize team-based care with the aim of ensuring equitable access to essential diabetes management tools. We urge policy makers to prioritize primary care workforce development, enhance reimbursement models, and implement strategies to mitigate disparities in diabetes care. Evidence reviewed here highlights the critical need for a comprehensive, multidimensional approach to diabetes management in primary care, emphasizing the importance of decisive action by policy makers to equip primary care professionals with the necessary resources and support to effectively address the nation's diabetes epidemic.
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Annals of family medicine · Nov 2024
Are Direct Primary Care Practices Located in Health Professional Shortage Areas?
Direct primary care (DPC) is a model of health care delivery that relies on membership fees for service; however, it has been criticized as potentially worsening the shortage of primary care physicians. We sought to compare the distribution of DPC practices in the United States to that of non-DPC primary care and assess the overlap with Health Resources and Services Administration designated health professional shortage areas (HPSAs). ⋯ We found that DPC practices were less likely to be in HPSAs overall and less likely to be in a high-priority-need HPSA but more likely to be in a rural or partially rural HPSA compared to primary care physicians. There is ample opportunity to grow DPC presence in many HPSAs that remain underserved, especially high-priority HPSAs in urban areas.
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Annals of family medicine · Nov 2024
Learning From Ervin's Care: Ethics, Health Care Finance, and Human Connection.
A 70-year-old man with complex multimorbidity and intellectual disability was my patient for the last 5 years of his life. He taught me important lessons about the challenges of practicing medicine as a primary care physician. ⋯ The gaps in his care revealed shortcomings of the US health care system, but his care in his final years also showed some of the bright spots in coordinated, team-based care. Most importantly, caring for this patient taught me about the rewards of the human connections that primary care physicians establish with their patients.