Harvard Medical School has announced a $30 million initiative to transform primary care education and training through the creation of the Center for Primary Care. The Center puts Harvard Medical School at the forefront of an emerging trend across academic medical centers (AMCs). Taking stock of the state of primary care, many AMCs are working to address shortfalls between their status quo configuration and what would most likely be needed to function as an accountable care organization (ACO).
Harvard Taking Steps to Strengthen Primary Care
While catalyzed by a large anonymous donation, the Center is the culmination of Harvard's year-long collaborative to evaluate the state of primary care and create recommendations to strengthen and grow primary care.
AMCs Nationwide Confronting a Change in Model
AMCs across the country are taking stock of the state of primary care; anecdotally, we hear many organizations discussing the possibilities of expanding their focus on primary care programs. These changes are driven by the industry-wide recognition of the importance of primary care in making health care delivery more effective and sustainable across populations; in addition, at an organization level, AMC leaders also acknowledge that historic underinvestment in primary care is a strategic problem that places AMCs at a disadvantage in creating ACOs.
Anecdotal reports from our research estimate that primary care physicians represent only 15%-20% of the faculty at most AMCs today. In comparison, primary care physicians account for 40%-50% of the medical staff at integrated delivery systems and organizations with a significant portion of capitated contracts--organizations taking total population risk today.
Working Against the Clock
As leaders in education and research, AMCs are well-positioned to grow the number of new physicians entering primary care and evaluate novel delivery models. However, given the five-year lag between a student's choice of specialty and completion of training, it will be challenging for AMCs to make new primary care training investments quickly enough to meet market demands.
For that reason, it will probably be necessary for most AMCs' playbooks to include not only new investments in primary care training, but also enhancements to their primary care delivery infrastructure as well as new relationships with local primary care and community physicians who can start delivering advanced primary care services to patients right away.