Lessons from the Trenches — A High-Functioning Primary Care Clinic

Bodenheimer, Thomas

doi:10.1056/nejmp1104942

Cited by 51 publications

(36 citation statements)

References 2 publications

(1 reference statement)

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“…Other practices, such as Clinica Family Health Services, 26 have adopted the use of primary care teams or "pods" that group physicians to ensure better access while maintaining continuity of care through electronic health records. 27,28 The primary care practices studied by Patricia Parkerton and colleagues in Washington State 29 provide examples of a "shared practice" approach under which physicians accept joint responsibility for patient care.…”

Section: Study Resultsmentioning

confidence: 99%

Primary Care Physician Shortages Could Be Eliminated Through Use Of Teams, Nonphysicians, And Electronic Communication

Green¹,

Savin

Lu³

2013

Health Affairs

209

143

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Most existing estimates of the shortage of primary care physicians are based on simple ratios, such as one physician for every 2,500 patients. These estimates do not consider the impact of such ratios on patients' ability to get timely access to care. They also do not quantify the impact of changing patient demographics on the demand side and alternative methods of delivering care on the supply side. We used simulation methods to provide estimates of the number of primary care physicians needed, based on a comprehensive analysis considering access, demographics, and changing practice patterns. We show that the implementation of some increasingly popular operational changes in the ways clinicians deliver care-including the use of teams or "pods," better information technology and sharing of data, and the use of nonphysicians-have the potential to offset completely the increase in demand for physician services while improving access to care, thereby averting a primary care physician shortage.

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Section: Study Resultsmentioning

confidence: 99%

Primary Care Physician Shortages Could Be Eliminated Through Use Of Teams, Nonphysicians, And Electronic Communication

Green¹,

Savin

Lu³

2013

Health Affairs

209

143

View full text Add to dashboard Cite

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“…Practices that focus on these aspects are increasingly making communications available to patients via telephone and a web portal or e-mail, 35 and are working out mechanisms for channeling communications to appropriate staff in care teams. 36,37 The therapeutic relationship is increasingly understood to be central to health and healing and to the patient experience. Most research on this topic has been in psychiatric and psychological care, where effective relationships with therapists have been shown to be associated with better care outcomes.…”

Section: Direct Care Activitiesmentioning

confidence: 99%

Achieving Value in Primary Care: The Primary Care Value Model

Rollow

Cucchiara

2016

Ann Fam Med

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The patient-centered medical home (PCMH) model provides a compelling vision for primary care transformation, but studies of its impact have used insufficiently patient-centered metrics with inconsistent results. We propose a framework for defining patient-centered value and a new model for value-based primary care transformation: the primary care value model (PCVM). We advocate for use of patient-centered value when measuring the impact of primary care transformation, recognition, and performance-based payment; for financial support and research and development to better define primary care value-creating activities and their implementation; and for use of the model to support primary care organizations in transformation.

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“…When these more meaningful measures are combined with team-based care and other workplace reforms, both efficiency and work satisfaction may improve. [42][43][44][45][46][47][48][49][50][51] Expansion of medical school capacity is already underway, 52 but is not expected to produce the necessary growth in primary care physicians because student selection for primary care careers is falling or stable. 22,[52][53][54][55] The Council on Graduate Medical Education recently estimated that the nation's needs will not be met until 40 % of practicing physicians are in primary care 5 -a percentage that cannot be achieved with the current 20 % selection rate.…”

Section: Commonly Discussed Solutions To the Adult Primary Care Physimentioning

confidence: 99%