C. Seth Landefeld

Seth Landefeld will spend his fellowship year writing a series of papers that address the challenges facing primary healthcare (which some have termed the “primary care crisis”).  The goals of this work are to build understanding of the crisis and to catalyze efforts that will lead to its resolution.  Although primary care is the only health care that consistently improves the health and well-being of communities, reduces health inequities, and lowers total health care costs, primary care is not accessible to many Americans.  Primary care spending has decreased 25% in less than a decade, and the number of US primary care physicians has plummeted.  Many rural counties have no primary care clinicians, and most medical centers and healthcare groups now have difficulty hiring primary care physicians.  Loss of primary care affects disproportionately those who have fewer socioeconomic resources, worsening inequities in health care.  Landefeld will articulate a taxonomy for primary care, describe the crisis and its historical basis, propose a conceptual model for the crisis, and suggest pragmatic, feasible strategies that may advance primary care and its benefits.

Landefeld is a physician, geriatrician, and health services researcher whose research has developed and tested multi-disciplinary interventions to improve the health of vulnerable older people with serious illness.  Most recently, as chair of the department of medicine at the University of Alabama at Birmingham, he transformed the largest department of medicine in the deep south to advance health and to create the future of health care through major clinical, educational, and research initiatives. Landefeld was a fellow at CASBS in 2008-09.