A Prevention-First Approach: If We Want to Keep Americans Healthier and Out of the Hospital, We Need More Physicians Trained Outside of Hospitals

Upon the passage of President Trump’s “One Big Beautiful Bill,” we must reflect that while there are many perspectives on its future impact and implications, codifying the administration’s economic policy and meeting President Trump’s ambitious goal of passage is no small feat. It must be recognized that President Trump’s interests hold significant influence over this Congress. In order to move preventive medicine forward, we must underscore to President Trump and the 119th Congress the vital role preventive medicine can play in transforming our sick-based health system to one that is focused on wellness and health promotion.

Considering President Trump and Secretary Kennedy’s charge to “Make America Healthy Again,” we at ACPM are aligned in the perspective that our health system should transform into one that prioritizes upstream prevention rather than focusing all our energies on treating people after they have become ill. ACPM advocates that we can’t “Make America Healthy Again” until our physician population is well-versed in disease prevention and health promotion.

In 2024, the American Board of Preventive Medicine reported that 2,931 physicians were certified in Public Health and General Preventive Medicine, representing less than 0.5% of the physician workforce. Now, more than ever, it is necessary to increase the number of physicians with expertise in public health and prevention to solve problems upstream, prevent chronic disease, enable Americans to live longer, healthier lives and ease the increasingly overwhelming burden on our healthcare system.
 

ACPM has taken extensive measures to educate the administration and Congress that our health system will never be able to keep people healthy and out of the hospital if our medical education system doesn’t appropriately train the next generation of doctors in prevention. The Medicare Graduate Medical Education (GME) program, which we have used for decades, is clearly failing the people that it was intended to serve — something must change. If President Trump and Secretary Kennedy want to keep Americans out of the hospital, they need to ensure more physicians are trained outside of the hospital.
 

The main obstacle blocking the training of more physicians in preventive medicine is not the institutions willing to train such physicians, but the paucity and instability of federal funding to support such training programs. Funding preventive medicine and other non-hospital, community-based physician training opportunities is a common-sense solution to shift our physician workforce’s focus from end-stage chronic disease treatment to one that recognizes, addresses and reduces the disease burden on Americans and keeps them healthy — before preventable diseases become debilitating, deadly and incredibly expensive.
 

To be sure, there are many areas at the interface of our federal government and the U.S. healthcare system that will require robust debate, education and advocacy; but at this juncture, the single greatest challenge facing our specialty is assuring adequate and sustained GME funding and an adequate supply of physicians in the preventive medicine pipeline. The impact of the specialty — including your, your colleagues’ and your future colleagues’ work — will cease to exist if there is no longer a pathway for training preventive medicine physicians. This funding priority and paradigm shift in medical education from hospital-focused care to community-based preventive care is also a lynchpin to making and keeping Americans healthier.
 

Therefore, in the weeks and months to come, ACPM will recommend strategies for Congress and the administration to improve our physician workforce’s ability to reduce the disease burden for both individuals and populations. Our proposed recommendations will address necessary changes throughout the medical education continuum, from medical school through GME and lifelong continuing medical education. ACPM looks forward to moving the needle forward for preventive medicine, collaborating wherever possible to ensure the American health system puts prevention first.