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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Underinvestment Undermines Primary Care
- Primary care is underfunded yet handles over a third of visits while receiving under 5% of spending.
- This chronic underinvestment plus increased administrative burden has eroded workforce capacity.
Training In A Narrowed Clinical Reality
- Bob Phillips describes training residents while managing an aging, complex panel and lost routine urgent care cases.
- He warns trainees now miss relationship-building and comprehensive care exposure in current training models.
AI Helps Documentation But Cannot Replace Relationship
- Ambient AI reduces documentation burden and many clinicians report less burnout from using it.
- But AI cannot replace the relational role of primary care and is limited by poor EHR data interoperability.