Picture this: Hundreds of family physicians and future family physicians arriving on the steps of the U.S. Capitol to share the top challenges they face and to ask their leaders to make a purposeful investment in primary care. They’ve earned the right to make this request through the hard work, long hours, and comprehensive care they’ve offered patients and their families across the country. They served on the front lines of the COVID-19 pandemic, they’ve helped vaccinate patients throughout a tripledemic, and they’ve strived to create healthier communities. Now, they’re ready to be heard.
This week, family physicians, residents, and medical students will have critical conversations with policymakers about the importance of primary care and family medicine. We will share stories from our patients and their families. We will outline how we shape our communities for the better. And ultimately, we will ask for their support in three key areas to protect our patients and our practices: ensuring adequate Medicare payment, making investments to support and strengthen the primary care workforce, and alleviating the administrative burden that prevents physicians from optimizing their time with patients.
Family physicians have already seen the ramifications of an unsustainable Medicare payment system—physicians retiring early, practices shutting their doors, an inability to pay practice expenses. Reform is urgently needed to ensure that practices can provide high-quality care to our nation’s seniors and to break down barriers to accessing care.
Updating physician payments to account for inflation is an important first step. The Medicare physician payment system is the only Medicare payment system lacking an annual inflationary update. Thankfully, a bipartisan, common-sense solution has already been introduced: the Strengthening Medicare for Patients and Providers Act (H.R. 2474). This would help modernize Medicare physician payment, protect access to care, and provide physicians and patients with the stability they need.
Our strong long-term relationships with our patients are part of what makes family physicians the backbone of medicine. However, prior authorizations often block timely patient care. According to the American Medical Association, more than 90 percent of physicians report that prior authorizations—a burdensome process that mandates physicians obtain pre-approval for treatments or tests before providing services— result in care delays for patients. We know all too well what these unnecessary delays can lead to: patient frustration, worsening symptoms, and physician burnout. Family physicians this week will encourage lawmakers to pass smart legislation, such as the Safe Step Act, to create a clear process for patients and physicians to seek reasonable exceptions to step therapy. We will urge Congress to streamline the prior authorization processes.
As physicians, we know that becoming a doctor in the U.S. is no easy feat. And it’s certainly an expensive one. We need congressional support against the crippling medical student loan debt that makes a career in medicine unattainable for many. We support legislation such as the Resident Education Deferred Interest (REDI) Act, which allows individuals to defer the interest on their federal student loans during medical residency, saving significant money.
We must also ensure that physicians are practicing where patients most need them—in communities where patients must travel far distances to access care. In towns that have only one doctor. In cities where public transportation isn’t accessible. Legislation such as the Conrad State 30 and Physician Access Act will help remedy this by allowing foreign doctors studying in the U.S. to remain here following their residency in exchange for practicing in medically underserved areas, where they can improve equitable, timely access to care.
Policymakers can act now by supporting and expanding programs that have been proven to help address physician shortages and maldistribution in medically underserved and rural areas. This includes funding for the National Health Service Corps and Teaching Health Centers as well as expanding Medicare Graduate Medical Education slots and targeting them to programs in areas and specialties of need.
Every day, family physicians show up, ready to tackle whatever health problems our patients are facing, whether it’s a pandemic, a mental health crisis, or a routine follow-up appointment. But we can’t do it all by ourselves. We need federal policies that enable us to do what we do best: care for our patients. Congress, will you help us?
Tochi Iroku-Malize, Sterling N. Ransone, Jr., and Steven P. Furr are family physicians. They are, respectively, president, board chair, and president-elect, American Academy of Family Physicians.
