Health Equity: The Only Path Forward for Primary Care

Area of Science:

• Primary Care Medicine
• Health Services Research
• Health Equity

Background:

• The 2021 National Academies of Sciences, Engineering, and Medicine (NASEM) report outlines key objectives for high-quality primary care.
• Existing frameworks for primary care may not fully address the needs of under-resourced communities.

Purpose of the Study:

• To propose a response to the NASEM report from the perspective of early career primary care physicians.
• To highlight the importance of health equity as a foundation for future primary care.
• To extend the traditional '4 Cs' of primary care to be more inclusive.

Main Methods:

• Appreciative inquiry was used with nine junior primary care leaders from diverse backgrounds.
• Perspectives of early career clinicians were highlighted.
• The study proposes an extended model for primary care.

Main Results:

• An extended model of primary care is proposed, including 5 additional Cs: convenience, cultural humility, structural competency, community engagement, and collaboration.
• Support for the NASEM report's priorities and focus on health equity.
• Recommendations for community investment and preparatory programs to encourage diverse healthcare professionals.

Conclusions:

• Health equity must be foundational in primary care.
• The proposed extended 'Cs' enhance inclusivity for under-resourced populations.
• A blended value-based care model with social complexity risk adjustment is supported.