Advocacy and policy news for internists

Preserving Patient Access to Primary Care Act Introduced in House

The Preserving Patient Access to Primary Care Act, H.R. 7192, was introduced in the House of Representatives by Rep. Allyson Schwartz (D-PA) on Sept. 27.

ACP worked closely with Rep. Schwartz and other primary care organizations -- including AAP, AAFP and AOA -- to craft the new legislation. "We are confident the bill addresses the reasons for the shortfall in access to primary care services in a comprehensive fashion," pointed out ACP President Jeffrey P. Harris, MD, FACP. "The legislation would put Congress on record as finding that there is a growing crisis in access to primary care and that primary care medicine is critical to improving outcomes and reducing costs."

"Primary care in the United States is in jeopardy. Despite the fact that, for most, primary care is the lynch-pin to care coordination and preventive health care, fewer and fewer medical students are entering primary care professions. As someone committed to ensuring that every American has access to quality, affordable health care, I understand deeply how vital it is that we increase the number of physicians practicing primary care medicine," noted Rep. Schwartz. "This bill takes common sense, effective steps, including expanding medical education grants, scholarships, debt forgiveness and loan repayment initiatives, to address many of the main challenges facing primary care doctors or those interested in entering the field."

The bill outlines a series of different measures designed to help support the field of primary care. The legislation:

  • requires a study to recommend the designation of primary care as a shortage profession, as long as certain criteria are met;
  • provides recruitment and retention incentives, through grants, scholarships, and loan forgiveness, to encourage medical students to choose careers in primary care;
  • establishes measures to support and expand the patient centered medical home (PCMH) model of care to ensure that primary care practices are able to achieve the infrastructure and have the capability to provide patient-centered, physician-guided coordinated care; and,
  • proposes comprehensive reforms of payment systems under Medicare, to support, sustain, and enhance the practice of primary care.

A just-completed study was published in the Sept. issue of JAMA that showed how critical the situation is becoming. The JAMA survey results of 1,200 fourth-year medical students showed that only 2 percent plan to go into primary care internal medicine. In a similar survey in 1990, the figure was 9 percent.

With Congress adjourned, the legislation likely will not be taken up until 2009. Rep. Schwartz plans to re-introduce the bill in the new 111th Congress and Sen. Maria Cantwell (D-WA) plans to introduce a companion Senate bill at that time.

During the next few months, ACP will be working with Rep. Schwartz and Senator Cantwell and other supportive members of Congress to urge as many members of Congress as possible to become original co-sponsors when the bill is introduced again in early 2009. ACP members are urged to contact their legislators about becoming original cosponsors of the Schwartz and Cantwell bills when they are introduced in the new Congress.

October 22, 2008