Primary Care in Crisis:  A Medical Student Perspective and Call to Action

The UCSF Primary Care Health Policy Scholars

 As all medical students interested in primary care know, announcing our decision to pursue our chosen specialty is usually met with some version of surprise and the phrase, “Wow, good for you.” While decades ago, our interests would have been unremarkable, today, pursuing a career in primary care is perceived by many to be a brave but reckless choice.

To those of us who are medical students and just launching our lifelong careers as physicians, it is no secret that primary care is disproportionately shouldering the burden of a healthcare system in crisis. The US healthcare system we are inheriting is the most costly, least effective, and least equitable among high-income nations. Chronic underinvestment in primary care has led both healthcare costs and wait times to reach all-time highs, along with worsening health inequities and health worker burnout.

As future primary care physicians, we are passionate about delivering equitable, affordable, and effective primary care services to patients. Yet we have profound concerns about the ability of the current system to support our ambitions and give us opportunities for meaningful, long-lasting careers. We have two options: either stand idly by becoming actors in an unjust system or join the movement for radical system-wide change.

This understanding drew a dozen of us medical students to become the inaugural cohort of the UCSF Health Policy Scholars Program. The Health Policy Scholars Program is a new initiative for medical students within the Primary Care Leadership Academy sponsored by the UCSF Department of Family and Community Medicine. The program supports students’ development of health policy knowledge and skills needed to revitalize primary care. Through the program, we have collaborated with researchers, healthcare workers, patients, and policymakers and produced a policy brief that advocates for a healthcare system that prioritizes robust primary care services for all.

In our recently released policy brief, “Healing the Foundation: The Critical Importance of Investing in Primary Care in California,” we demonstrate that strong primary care systems improve health outcomes and equity while reducing overall healthcare expenditures. We also advocate for radical change in our state’s valuation of primary care, utilizing existing state legislation as a vehicle for change. We hope to contribute a medical student voice to the long-standing movement to advance healthcare in California and across the US. We are grateful to have received overwhelmingly positive support when distributing our policy brief at conferences and when presenting our ideas to local policy groups and coalitions. We’ve received praise for engaging with policy this early in our careers. However, the choice is simple when the alternative is to watch our peers burn out and our communities be unable to access care.

This is just the beginning. We have ambitions to deliver our brief directly to members of the state legislature and plan to design a primary care policy and advocacy curriculum that could be implemented at medical schools around the country. We hope to inspire other medical students to take an active role in creating a system of healthcare we will be proud to practice in for years to come.

UCSF Primary Care Health Policy Scholars

Eushavia Bogan, Daniel Chan, Anthony Diep Rosas, Kweku Djan, Nina Djukic, Kea Edwards, Anna Claire G. Fernandez, Maxwell Ho, Melissa Ma, Sophie Oubaha, Ananya Somasekar, Zakiyyah Winston