Date of Award


Document Type

Open Access

Degree Name

Bachelor of Arts



First Advisor

Melinda Goldner




primary care, medicine, infrastructure, health care


Primary care medicine is an essential component of the U.S. health care system, yet there is no other part of the health care system that is in greater trouble right now. Primary care is undergoing profound change in the United States, as evidenced by an increasingly sick population along with the concurrent decrease in the supply of doctors to care for that population. The passage and the Supreme Court’s upholding of the constitutionality of the Affordable Care Act (ACA) is but another confirmation of the need to improve upon primary care in the U.S. In this paper, the major deficiencies in the primary care infrastructure in the U.S. are outlined. In addition, analysis of health care systems of countries that have substantial primary care systems, namely the United Kingdom, Spain and Italy, was performed to identify solutions to mitigate U.S. deficiencies. Innovative U.S. models and initiatives spurred by the ACA were also assessed. The results of this analysis indicate that to make substantive change to the U.S. health care system requires community directed initiatives based on the medical home model and centered on the primary care physician.

Included in

Primary Care Commons