Is There a [Primary Care] Doctor in the House? Implications of the Affordable Care Act on Graduate Medical Education and Primary Care Physician

As a result of a number of factors including compensation, practice environments, and socialization in medical school, there is an accelerating shortage in the number of primary care physicians in the U.S. In 2010, in its 20th Report to Congress, the Council on Graduate Medical Education called for increasing the percentage of primary care physicians from 32% to at least 40% to address this shortage. With the implementation of the Affordable Care Act, millions of uninsured and underinsured persons have become insured and enter the mainstream of healthcare. The Affordable Care Act contains several important provisions to expand the primary care workforce. Graduate medical education is central to development of this workforce. This study aims to answer the following research question: How is an individual primary care graduate medical education residency program affected by and responding to the implementation of the Affordable Care Act and the current and projected primary care physician shortages exacerbated by the Affordable Care Act? Case study methods were used to pursue this question in the context of a primary care graduate medical education residency program. Several useful implications for teaching, learning, and policy implementation emerged from this inquiry based on following themes, which emerged; the Affordable Care Act Impact, Model of Care, Advocacy, Resident Encouragement, and the Joy of Practice. This study found for the case study primary care residency program; a positive impact by the Affordable Care Act implementation, the Patient-Centered Medical Home Model of Care is well suited for primary care residency training and faculty role modeling including the Joy of Practice may encourage residents to pursue primary care practice post residency