Primary Care Technicians

A Solution to the Primary Care Workforce Gap

Published in: Health Affairs, v. 32, no. 11, Nov. 2013, p. 1893-1898

Posted on RAND.org on November 01, 2013

by Arthur L. Kellermann, John W. Saultz, Ateev Mehrotra, Spencer S. Jones, Siddhartha Dalal

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Research Questions

  1. Is the primary care workforce gap likely to be closed using current strategies?
  2. Are there other approaches that would be more successful?

Efforts to close the primary care workforce gap typically employ one of three basic strategies: train more primary care physicians; boost the supply of nurse practitioners or physician assistants, or both; or use community health workers to extend the reach of primary care physicians. In this article we briefly review each strategy and the barriers to its success. We then propose a new approach adapted from the widely accepted model of emergency medical services. Translating this model to primary care and leveraging the capabilities of modern health information technology, it should be possible to create primary care technicians who can dramatically expand the impact and reach of patient-centered medical homes by providing basic preventive, minor illness, and stable chronic disease care in rural and resource-deprived communities.

Key Findings

Current strategies for closing the primary care gap—including training more primary care physicians, increasing the supply of nurse practitioners or physician assistants, or using community health workers—may not be successful.

In this paper, the authors propose another approach in which primary care technicians, a new type of primary care provider, extend the reach of primary care physicians using structured guideline care and mobile technology.

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