Basic Health Access Policy for Primary Care 

Robert C. Bowman, M.D.    rcbowman@atsu.edu   

Ultimate Health Access Recovery: Permanent Primary Care By Training Design The Health Access Medical School: The Remaining Solution for Health Access at the Current Time

Policy Within and Between States States that Concentrate and States that Distribute - States that Concentrate Benefit the Most While Most US States are Left Behind. Understanding Cost, Quality, and Access Requires Understanding Distributions of Health Resources, Physicians, Specialists, and Economics  States that fail to understand Concentration Versus Distribution - Fail in More than Health Access

policy Missing Persons: Eliminations of Primary Care in the 1980s and 2000s    Compare the graphics demonstrating production of primary care to identify the decades with decreased production and retention of primary care. Also remember the insufficient health access production extending for decades prior to the 1970s. Then consider the deficits being built now, for the next decade, and potentially beyond.

policy Summary - Why 5000 More Family Medicine Graduates Is the Remaining Solution for Recovery of Basic Health Access in the United States Maximal primary care, maximal distribution to all populations in need, maximal retention in primary care, 6 - 10 times more primary care per graduate, and far less decline in primary care contributions compared to other primary care forms are all logical, common sense reasons to increase family medicine residency graduates to 8000 per year by 2020.

policy Primary Care Past, Present, and Future Using the Most Important Criteria for Primary Care - Actually Remaining in Primary Care and Delivering Primary Care Make the comparison between 15,000 more flexible forms with 5000 more IM, 5000 more NP, and 5000 more PA graduates as compared to 5000 more family medicine residency graduates. Flexible training forms fail to address massive and growing primary care deficits while the family medicine intervention moves the nation toward most needed health access. Graphics illustrate the changes.  

policy Nebraska: A Practical Application of Experiential Place and Workforce  With changes in admission, in training, and in career choice, where is Nebraska heading. Can the state produce and retain the necessary physicians when other states have higher concentrations of physicians that attract physicians from all lesser concentrations, including states with lesser concentrations. What happens when family physicians, the bulk of health access for Nebaskans, are produced at half the levels of a decade ago, no longer drift in from others states, and no longer have the greater salaries and value of broadly trained family physicians? Then consider most of the states in the United States similar to Nebraska or with large regions of population similar to Nebraska.

table Slide Show Brief Clip - Most Needed Health Access Careers By Birth Origins - Decreased Probability of Admission is Associated with Increased Probability of Most Needed Health Access 

table The Health Access Medical School: The Only Solution for Health Access at the Current Time

table Older Age Graduates Consistently Contribute More to Most Needed Health Access: Confirmation of the Theme of Those with Lower Probability of Admission that Contribute the Most in all of the most needed workforce areas

table Admission Probability and Experiential Place: Admission Ratios and Physician Origins Consistently the physicians most closely associated with concentrations have highest probability of admission and lowest probability of being found in most needed health access careers and locations. Movements toward more exclusive in origins represent a problem for most of the US population in basic health access needs.

table Real Diversity Extremes in Physician Workforce - Diverse admissions are often considered "different" but are actually more normal in origins, career choice, and in distribution where most needed. Extremely different children of the most concentrated origins are extremely exclusive and make exclusive career and location choices. Only a small fraction of the American population is as extreme as the physicians that enter the US workforce. And the nation's physicians are getting even more exclusive/diverse/different in origins.

Principles of Health Access Summary Points     Steps to Health Access     Basic Health Access Concepts To Review 

Foundation of Basic Health Access Primary Care

Atlas of Basic Health Access  

www.basichealthaccess.org

www.physicianworkforcestudies.org

www.ruralmedicaleducation.org