The Impact of Health Capital on Primary Care Access: Cultivating Equity in a Broken System.

Abstract

Health capital, or the aggregate of an individual's resources that have the capacity to affect health, contributes to expedited access to primary care. This is of particular relevance in the era of significant primary care access delays in the USA. Primary care physicians (PCPs) may receive requests to provide expedited primary care services to individuals of high health capital, while individuals of low health capital are left to access and navigate the primary care system independently. Granting priority requests for primary care access to individuals of high health capital becomes inappropriate preferential access to care, leading to consequences including heightened health disparities, an exacerbation of already poor primary care access for low health capital individuals, and moral distress among PCPs. Systemic change in primary care access is needed to limit improper expedited access to care among high health capital individuals and ensure equitable access for all patients. When prioritized access is granted, this should be medically or ethically justified - patients with urgent medical needs, frequent emergency department visits, and/or limited socioeconomic resources should be first in line to receive prioritized access.