As the new president of ACLGIM, I am delighted to work with a dedicated and innovative group of leaders. One of the most important issues facing our group, as outlined by Dr. Earnest in the last ACLGIM forum, is the “Recruitment and Retention of Academic Generalists” as it relates to the future of Primary Care. To that end, ACLGIM engaged the consulting group, Civic Canopy, for a day-long session at the annual Hess Institute Meeting in May 2023. The session was hugely successful with 100 faculty ACLGIM attendees and more on the waiting list of participants. Discussion was lively and passionate, and it became clear how important this topic is to so many of our group, not to mention the well-being of our faculty and the health of our nation. After large-group and small-group breakout discussions, the issues to address were collated by the Canopy consultants and provided back to ACLGIM leadership in a multipage report.

The following three priorities areas were identified, along with areas of focus:

1. Enhance Focus on Team Based Delivery of Care:

  • Provide high functioning teams with all members working at the “top of their license”
  • Leverage the electronic medical record for maximal performance
  • Develop new outcome metrics that capture the work of the team and focus upon patient and physician centered outcomes (as opposed to common productivity measures currently in use).

2. Rebalance Primary Care Compensation to Align with Work:

  • Recognize the increased workload caused by the explosion of portal-based, asynchronous work
  • Advocate improved reimbursement for both Fee For Service and Value-Based Care patient care work lead by primary care physician
  • Develop a toolkit to help leaders present the business case for enhanced compensation.

3. Increase Learner Exposure to and Training Time in High-Functioning Primary Care Settings:

  • Advocate with ACGME and LCME to require an increased time of exposure to and training in primary care
  • Build a pipeline of future primary care physicians with outreach as well as creative hiring practices designed to recruit trainees early in their career
  • Reinvigorate the “Proud to be GIM” campaign and activities at academic medical centers.

A long list of possible tactics to achieve these broader goals as generated by the ACLGIM faculty group was also provided and summarized.

The ACLGIM Executive Committee has now reviewed the report and we are in the process of prioritizing the most important and most actionable items to pursue. We have identified a lead for each of the priority areas and will be asking ACLGIM members to provide input on the next steps we should take as a group. We would like to take actions that have a good chance of making a difference. Please contact us if you have a preference to participate on one of the three topics. Both I and the executive council of SGIM realize that addressing Recruitment/Retention now is imperative if Academic Primary Care is to survive and flourish. I look forward to more hearty discussion as we work to take action to extend the great work that has already been done.



ACLGIM, Advocacy, Health Policy & Advocacy, Leadership, Administration, & Career Planning, Medical Education, Vulnerable Populations

Author Descriptions

Dr. Nadkarni ( is a professor and division chief of general, geriatric, palliative and hospital medicine at the University of Virginia School of Medicine. He practices in primary care at UVA and the Charlottesville Free Clinic in Charlottesville, VA