ImportanceStudies have suggested that greater primary care physician (PCP) availability is associated with better population health and that a diverse health workforce can improve care experience measures. However, it is unclear whether greater Black representation within the PCP workforce is associated with improved health outcomes among Black individuals.ObjectiveTo assess county-level Black PCP workforce representation and its association with mortality-related outcomes in the US.Design, Setting, and ParticipantsThis cohort study evaluated the association of Black PCP workforce representation with survival outcomes at 3 time points (from January 1 to December 31 each in 2009, 2014, and 2019) for US counties. County-level representation was defined as the ratio of the proportion of PCPs who identifed as Black divided by the proportion of the population who identified as Black. Analyses focused on between- and within-county influences of Black PCP representation and treated Black PCP representation as a time-varying covariate. Analysis of between-county influences examined whether, on average, counties with increased Black representation exhibited improved survival outcomes. Analysis of within-county influences assessed whether counties with higher-than-usual Black PCP representation exhibited enhanced survival outcomes during a given year of heightened workforce diversity. Data analyses were performed on June 23, 2022.Main Outcomes and MeasuresUsing mixed-effects growth models, the impact of Black PCP representation on life expectancy and all-cause mortality for Black individuals and on mortality rate disparities between Black and White individuals was assessed.ResultsA combined sample of 1618 US counties was identified based on whether at least 1 Black PCP operated within a county during 1 or more time points (2009, 2014, and 2019). Black PCPs operated in 1198 counties in 2009, 1260 counties in 2014, and 1308 counties in 2019—less than half of all 3142 Census-defined US counties as of 2014. Between-county influence results indicated that greater Black workforce representation was associated with higher life expectancy and was inversely associated with all-cause Black mortality and mortality rate disparities between Black and White individuals. In adjusted mixed-effects growth models, a 10% increase in Black PCP representation was associated with a higher life expectancy of 30.61 days (95% CI, 19.13-42.44 days).Conclusions and RelevanceThe findings of this cohort study suggest that greater Black PCP workforce representation is associated with better population health measures for Black individuals, although there was a dearth of US counties with at least 1 Black PCP during each study time point. Investments to build a more representative PCP workforce nationally may be important for improving population health.

This survey study uses data from the Association of American Medical Colleges National Sample Survey of Physicians to assess the prevalence and characteristics of US physicians with disabilities among a survey of 6000 practicing physicians.

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Key Points Question How did utilization of electronic consultations (eConsultations) change during the COVID-19 pandemic for US academic medical centers with mature eConsultation programs? Findings In this cohort study including 14 545 completed eConsultations, eConsultations as a proportion of all specialty consultations significantly increased in the first week of the pandemic. This held true for both English- and non-English–speaking patients and across all payer types, except for self-pay and uninsured patients. Meaning These findings suggest that eConsultations provided an accessible mechanism for clinicians to receive specialist input when in-person care was limited.