As the team care model and its focus on care coordination expand throughout the world of primary care, so do the “coordinator” analogies. For example if you like sports, you might view the primary care physician as the quarterback of the team or the coxswain of the racing boat. If your interests run to music the PCP is the conductor of the orchestra. For cinema buffs, he or she is the director of the film.Read More
Despite a growing interest in some of the “soft” skills related to medicine and the enduring hope that reform will provide a more fertile ground for change, healthcare has generally transitioned away from the time when physicians developed strong interpersonal bonds with patients. You can blame time restraints, the depersonalization potential of the EMR and the way doctors are paid. But whatever the cause, the fact remains that the doctor-patient relationship has suffered.Read More
As a practicing Family Medicine physician I was an early adopter of the electronic medical record (EMR) so I have long and personal experience with its advantages and disadvantages. Now, while working with practices across the country to help them transition to an effective Team Care model, I am also keenly aware of the compatibility and integration problems brought about by the plethora of different vendors and systems.
I know I share this EMR frustration with most primary care doctors, so it was particularly gratifying to see the efforts that the American Academy of Family Physicians (AAFP) is now directing toward solving some of the major challenges.Read More
While the direction of U.S. healthcare reform continues to include an air of uncertainty, one thing we can be sure of is that internationally, new ideas related to primary care medicine in general and the patient-centered medical home in particular, are coming soon. And a good part of that prediction is based on the fact that Dr. Paul Grundy was recently designated as one of the 12 original ambassadors for Healthcare DENMARK, a gateway for international stakeholders to experience the Danish healthcare system and its innovative healthcare solutions.Read More
Through the eyes of an individual physician, watching the major organizations representing primary care bring together their collective resources and energies is a gratifying and empowering experience. From the perspective of primary care practices across America and our field of medicine in general, it’s a unique opportunity to develop improved strategies and communications for the future.
Toward that objective we received some promising news late last month from Family Medicine for America’s Health, a coalition of primary care organizations (see the list below) that shares a basic vision of the role primary care medicine should play in heath care reform, regardless of the form it may ultimately take.Read More
In The Boys in the Boat, a masterful account of the University of Washington’s eight-oar crew in the 1936 Olympics in Berlin, author Daniel James Brown offers an insight into what it takes to develop a gold medal-winning team. He also describes the frustration of the university’s rowing coach who kept trying to put together the best combination of people, a task he finally realized relied on temperament, personality and other intangibles as much as it did on physical strength and rowing skills.
Each time he assigned nine young men to a racing shell – eight rowers and a coxswain – he was fulfilling the basic requirement of building a team.Read More
Although the concept and basic principles of the medical home were introduced as far back as 1967 by the American Academy of Pediatrics, the current delivery system innovation represented by the Patient-Centered Medical Home (PCMH) is of more recent vintage. And while this model of team-based, coordinated care has many advocates, no one has served as more of a singular champion for the PCMH than Paul Grundy, MD.
As IBM’s Global Director of Healthcare Transformation and the president of the Patient-Centered Primary Care Collaborative, Dr. Grundy has spent much of the past decade working with an international network of thought leaders, industry experts and medical practitioners.Read More
This surgeon walks into an operating room and nobody is there except the patient. If that sounds like the beginning of a joke consider that the patient waiting for the procedure wouldn’t find it very funny.
A successful surgery requires the close cooperation of a number of operating room personnel. It relies on their familiarity with their specific roles, their preparedness and their ability to execute their responsibilities quickly and confidently.Read More
As an integral part of the diagnostic process, medical practitioners have relied on visual cues throughout history. Even today, the amount of information that can be gathered through technologically-unaided observation is astounding. As it turns out, the same kind of criteria applied to a primary care waiting room can tell us a great deal about the health of a physician practice in general and the condition of the exam room in particular.Read More
In a comprehensive analysis published recently in the Archives of Internal Medicine, more than 7,000 physicians were surveyed on their quality of life and job satisfaction. Almost half of them reported at least one symptom of burnout and the overall rate was considerably higher than other U.S. workers even after adjusting for a range of appropriate variables.
The doctors described their symptoms with words like “overwhelmed”, “exhausted”, “detached” and “frustrated”.Read More