Renee Butkus, BA; Katherine Rapp, BS; Thomas G. Cooney, MD; Lee S. Engel, MD; for the Health and Public Policy Committee of the American College of Physicians *
Financial Support: Financial support for the development of this position paper came exclusively from the ACP operating budget.
Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-2410.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Christina C. Wee, MD, MPH, Deputy Editor, reports employment with Beth Israel Deaconess Medical Center. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Yu-Xiao Yang, MD, MSCE, Deputy Editor, reports that he has no financial relationships or interest to disclose.
Corresponding Author: Renee Butkus, BA, American College of Physicians, 25 Massachusetts Avenue NW, Suite 700, Washington, DC 20001.
Current Author Addresses: Ms. Butkus and Ms. Rapp: American College of Physicians, 25 Massachusetts Avenue NW, Suite 700, Washington, DC 20001.
Dr. Cooney: Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239.
Dr. Engel: Louisiana State University Health Sciences Center, 1542 Tulane Avenue, New Orleans, LA 70112.
Author Contributions: Conception and design: R. Butkus, K. Rapp.
Analysis and interpretation of the data: R. Butkus, K. Rapp, T.G. Cooney, L.S. Engel.
Drafting of the article: R. Butkus, K. Rapp, L.S. Engel.
Critical revision of the article for important intellectual content: R. Butkus, T.G. Cooney, L.S. Engel.
Final approval of the article: R. Butkus, K. Rapp, T.G. Cooney, L.S. Engel.
The American College of Physicians (ACP) has long advocated for universal access to high-quality health care in the United States. Yet, it is essential that the U.S. health system goes beyond ensuring coverage, efficient delivery systems, and affordability. Reductions in nonfinancial barriers to care and improvements in social determinants of health are also necessary. This ACP position paper calls for ending discrimination based on personal characteristics; correcting workforce shortages, including the undersupply of primary care physicians; and understanding and ameliorating social determinants of health. The ACP calls for increased efforts to address urgent public health threats, including injuries and deaths from firearms; environmental hazards; climate change; maternal mortality; substance use disorders; and the health risks associated with nicotine, tobacco use, and electronic nicotine delivery systems in order to achieve ACP's vision for a better U.S. health care system.
Butkus R, Rapp K, Cooney TG, et al, for the Health and Public Policy Committee of the American College of Physicians. Envisioning a Better U.S. Health Care System for All: Reducing Barriers to Care and Addressing Social Determinants of Health. Ann Intern Med. 2020;172:S50–S59. doi: https://doi.org/10.7326/M19-2410
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Published: Ann Intern Med. 2020;172(2_Supplement):S50-S59.
Cardiology, Coronary Risk Factors, Prevention/Screening, Smoking, Tobacco, Alcohol, and Other Substance Abuse.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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