JAMA Health Forum Conversations The Future of Primary Care in the US
Dec 12, 2025
Robert Phillips, MD, MSPH, is the Executive Director of the American Board of Family Medicine, specializing in primary care policy. He discusses the underinvestment in primary care and the burden of EHRs. Phillips explores the complexities of treating multimorbidity and the need for technology like ambient AI to alleviate burnout. He emphasizes the importance of integrating behavioral health and the necessity of training clinicians in rural settings. Lastly, he shares optimism about state-level innovations improving primary care access and funding.
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Teach Relationship-Based Primary Care
- Expose trainees to community-based, relationship-focused primary care outside academic centers.
- Give them longitudinal patient experience and integrated behavioral health to model comprehensive practice.
Give Clinicians Tools To Address Social Needs
- Provide concrete resources (social workers, vouchers, community services) so clinicians will screen and address social needs.
- Build mechanisms (e.g., prescription-like referrals) to close the loop on social determinants.
Direct Primary Care As A Design Signal
- Direct primary care shows patients will pay for reliable relationships and comprehensive access.
- Such models signal what health plans and systems should design toward to retain primary care value.