At the Intersection of Health, Health Care and Policy Cite this article as: Arthur L. Kellermann The Primary Care Workforce: The Author Replies Health Affairs, 33, no.1 (2014):182 doi: 10.1377/hlthaff.2013.1385
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Health Affairs is published monthly by Project HOPE at 7500 Old Georgetown Road, Suite 600, Bethesda, MD 20814-6133. Copyright © 2014 by Project HOPE - The People-to-People Health Foundation. As provided by United States copyright law (Title 17, U.S. Code), no part of Health Affairs may be reproduced, displayed, or transmitted in any form or by any means, electronic or mechanical, including photocopying or by information storage or retrieval systems, without prior written permission from the Publisher. All rights reserved.
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doi:
10.1377/hlthaff.2013.1385
The Primary Care Workforce: The Author Replies I share Edward Volpintesta’s view that the current premed curriculum, with its heavy emphasis on science and rote memorization, is ripe for reform. I have met many gifted people who would have gone on to become wonderful doctors except for the agony of organic chemistry. But rather than cut two years off of college, I’d rather see every premed master Spanish and take coursework in such topics such as ethics, biostatistics, and psychology.1 Even if it were possible, as Volpintesta proposes, to lop one or two years off of medical school, that would still be less efficient than producing primary care technicians, who could be ready for deployment after one year or less of community college (Nov 2013). Because Army medics and Navy independent duty corpsmen already possess these skills, they would be ready to join a primary care practice the day they retire from the military.
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The model my coauthors and I proposed is not intended to replace primary care physicians or nurse practitioners. Instead, it is intended to expand their impact and reach. For more than thirty years, we’ve failed to close the primary care workforce gap. If we keep doing the same thing and expect a different result, we’re unlikely to succeed. It’s time for a new approach. Harnessing wireless communication and mobile information technology, we can reengineer primary care to make it more affordable, accessible, and efficient. 2 Arthur L. Kellermann Uniformed Services University of the Health Sciences BETHESDA , MARYLAND NOTES 1 Emanuel EJ. Changing premed requirements and the medical curriculum. JAMA. 2006;296(9): 1128–31. 2 Jones SS, Heaton PS, Rudin RS, Schneider EC. Unraveling the IT productivity paradox—lessons for health care. N Engl J Med. 2012;366(24): 2243–5.
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The online version of this article, along with updated information and services, is available at: http://content.healthaffairs.org/content/33/1/182.1.full.html
For Reprints, Links & Permissions: http://healthaffairs.org/1340_reprints.php E-mail Alerts : http://content.healthaffairs.org/subscriptions/etoc.dtl To Subscribe: http://content.healthaffairs.org/subscriptions/online.shtml
Health Affairs is published monthly by Project HOPE at 7500 Old Georgetown Road, Suite 600, Bethesda, MD 20814-6133. Copyright © 2014 by Project HOPE - The People-to-People Health Foundation. As provided by United States copyright law (Title 17, U.S. Code), no part of Health Affairs may be reproduced, displayed, or transmitted in any form or by any means, electronic or mechanical, including photocopying or by information storage or retrieval systems, without prior written permission from the Publisher. All rights reserved.
Not for commercial use or unauthorized distribution Downloaded from content.healthaffairs.org by Health Affairs on May 14, 2015 by guest
Letters There is a limit of 300 words for letters to the editor. Health Affairs reserves the right to edit all letters for clarity, length, and tone. Letters can be submitted by e-mail, [email protected], or the Health Affairs website, http:// www.healthaffairs.org.
doi:
10.1377/hlthaff.2013.1385
The Primary Care Workforce: The Author Replies I share Edward Volpintesta’s view that the current premed curriculum, with its heavy emphasis on science and rote memorization, is ripe for reform. I have met many gifted people who would have gone on to become wonderful doctors except for the agony of organic chemistry. But rather than cut two years off of college, I’d rather see every premed master Spanish and take coursework in such topics such as ethics, biostatistics, and psychology.1 Even if it were possible, as Volpintesta proposes, to lop one or two years off of medical school, that would still be less efficient than producing primary care technicians, who could be ready for deployment after one year or less of community college (Nov 2013). Because Army medics and Navy independent duty corpsmen already possess these skills, they would be ready to join a primary care practice the day they retire from the military.
182
Health Affairs
The model my coauthors and I proposed is not intended to replace primary care physicians or nurse practitioners. Instead, it is intended to expand their impact and reach. For more than thirty years, we’ve failed to close the primary care workforce gap. If we keep doing the same thing and expect a different result, we’re unlikely to succeed. It’s time for a new approach. Harnessing wireless communication and mobile information technology, we can reengineer primary care to make it more affordable, accessible, and efficient. 2 Arthur L. Kellermann Uniformed Services University of the Health Sciences BETHESDA , MARYLAND NOTES 1 Emanuel EJ. Changing premed requirements and the medical curriculum. JAMA. 2006;296(9): 1128–31. 2 Jones SS, Heaton PS, Rudin RS, Schneider EC. Unraveling the IT productivity paradox—lessons for health care. N Engl J Med. 2012;366(24): 2243–5.
J a n u a ry 201 4
3 3: 1
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