Leadership Message: UC Davis School of Medicine faculty host summit on revitalizing primary care

Dear Colleagues,

I am proud to announce that a multi-disciplinary UC Davis School of Medicine team has organized the Summit on Revitalizing Primary Care to Recenter Relationships and Enhance Health – Rev PC for short – being held during Oct. 16-18.

A 2021 National Academies of Sciences, Engineering, and Medicine report found the state of primary care in the U.S. is far from ideal and worsening, the result of chronic under-investment and insufficient health care policy and workforce planning. The report called for a rebuilding of “the foundation of health care.”

Why should essentially everyone in the U.S. care about cultivating a more robust primary care base: patients, families, communities, physicians of all specialties, policymakers, payers, businesses, and the population at large?

For one thing, primary care is highly effective. Research has shown that greater exposure to primary care is associated with better population health and greater health equity. Further, the benefits of primary care come at relatively low cost. Among 12 wealthy nations with economies comparable to the U.S., all 12 have higher per capita spending on primary care yet lower total health care spending, better and more equitable health outcomes, and longer average life expectancies.

To achieve maximum benefit for all, primary care must be person and family centered, continuous, comprehensive and equitable, team based and collaborative, coordinated and integrated, and accessible. Longitudinal relationships between patients and primary care teams are at the core – the “secret sauce” of primary care. Unfortunately, low spending on primary care – which receives only about 5% of the $4.5 trillion in total annual health care spending in the U.S., despite accounting for 30% of visits – means most practices do not attain this ideal.

Without having the resources to meet most of their patients’ needs, overburdened primary care clinicians generate more referrals, worsening logjams in subspecialty access. Seeing these challenges, too few physicians are entering primary care to meet public need. In turn, increasing numbers of patients lack access to primary care, and those with access often face long waits for visits, due to over-empanelment of clinicians. Ultimately, many seek care in emergency departments for relatively minor issues that could have been handled in a physician’s office – or, at the other end of the spectrum, present late in the course of serious illness and require hospitalization and subspecialist consultation that could have been prevented with easy access to primary care.    

As patients, doctors, health systems, health insurers, businesses offering insurance, and other stakeholders increasingly feel the pain of poorly resourced primary care, a window for policy change has opened. Burgeoning state and federal efforts to revitalize primary care are yielding early successes. California has entered the arena, exemplified by the Office of Health Care Affordability recommendation that spending on primary care reach 15 percent of total medical expenses across all payers by 2034 – triple the current level. Efforts are also underway to adopt new payment models better suited to sustaining optimal team-based primary care than the prevailing fee for service. But there is still much more to do, and much more to be learned about how best to revitalize primary care.

And that’s where Rev PC comes in! Open to the public sessions on the mornings of Oct. 17 and 18 (free but requiring advance registration) will explore the state of primary care, relate exciting revitalization efforts, and provide visions of the future, through a health equity lens. Our esteemed speakers include:

• Ilana Yurkiewicz, M.D., Author of Fragmented: A Doctor's Quest to Piece Together American Health Care
• Christopher Koller, President, Milbank Memorial Fund
• Elizabeth Landsberg, J.D., Director, California Department of Healthcare Access and Information
• Kevin Grumbach, M.D., Professor, Family and Community Medicine, UC San Francisco
• john a. powell, J.D., Founding Director, Othering and Belonging Institute, University of California, Berkeley
• Mia Bonta, State Assemblymember, and Chairperson, Assembly Health Committee

A poster session from 10-11:15 a.m. on Oct. 17 will showcase UC Davis research relevant to primary care revitalization. I invite you to attend the public sessions!

Additionally, in closed working sessions a national committee of about 30 highly esteemed invited experts will convene to deliberate on current best practices and identify key issues and questions that have not yet been fully addressed around optimization of primary care – the latter representing opportunities for research and evaluation to further catalyze efforts. A white paper summarizing the output from the Summit is planned by the end of the year.

The Summit is supported by the Department of Family and Community Medicine, the Division of General Medicine and Bioethics, and the Center for Healthcare Policy and Research. On behalf of my Rev PC Planning Committee colleagues – Dr. Richard Kravitz, Dr. Courtney Lyles, Dr. Joshua Fenton, Dr. Mark Henderson, Dr. Kevin Grumbach (UC San Francisco), Dominique Ritley, and Eleanor McAuliffe –  I express my gratitude to Dr. Susan Murin, Interim Dean, and Dr. Kim Barrett, Vice Dean for Research, for helping to make the Summit possible with a School of Medicine Impact Symposium Award.

Rev PC embodies UC Davis’ long-standing, strong commitment to and high achievement in primary care. Please join us as we honor that commitment by working to rebuild the foundation of health care to the benefit of all.

Warm regards,

Anthony Jerant, M.D.
Professor and Chair, Department of Family and Community Medicine