Focus Session

Health in the Balance: Who Will Provide Primary Care?

Moderator

Lloyd Michener, M.D.
Professor and Chair, Department of Community and Family Medicine, Duke University Medical Center

Speakers

Larry Green, M.D.
Senior Scholar in Residence, Robert Graham Center; Professor of Family Medicine, University of Colorado

Christine Tassone Kovner R.N., Ph.D., F.A.A.N.
Professor, College of Nursing, New York University

Christine Tassone Kovner R.N., Ph.D., F.A.A.N.	Larry Green, M.D.

A strong primary care infrastructure is critical to the health of communities, but there is a sense of crisis due to declining interest in generalist careers among graduates of U.S. medical and osteopathic schools, and concern with future shortages.

Numerous studies have shown that physician assistants and nurse practitioners can also provide quality primary care services, including care for the chronically ill who are using a growing share of health services. This panel explored the changing role of physicians and nurse practitioners in the delivery of primary care.

J. Lloyd Michener, M.D., set the stage by reminding the audience that primary care is the largest access point for care, yet receives the smallest share of resources, and then at the conclusion of the session, described some of Duke's innovative efforts to work with the community to increase access to care.

Christine Tassone Kovner R.N., Ph.D., F.A.A.N., provided data on the number of nurse practitioners currently involved in primary care and noted that while they will continue to play a vital role, it is unrealistic to expect that they will be able to solve future shortages alone.

Larry Green, M.D., further illustrated the challenges facing primary care, including the currently ill-defined role of primary care physicians and the need for better reimbursements, and then outlined the benefits of the medical home model.

All three speakers emphasized that teamwork will be the model for the future and that the team will be broader than just health care clinicians and will involve patients and the community.

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