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Latest Posts

Today on the blog, we're introducing PCP's new Clinical Innovation Network (CIN) and its new blog Innovation in PracticeThis new blog is dedicated specifically to sharing clinical innovation with trainees. From time to time, like today, we'll run those blog posts here on Progress Notes, too. But if you don't want to miss a thing, make sure you follow them both.

By Peter Meyers

Countless articles, news stories and blog posts – including many right here – describe current primary care providers, and physicians in particular, as dissatisfied with their careers. These stories usually note that the physicians have become exactly the type of doctor they never thought they’d be: disengaged, disinterested, callous, and paternalistic. And, almost universally, the physicians blame a system that emphasizes short visits and long hours and breeds burnout. Those burned-out providers essentially have three choices: Continue to be miserable; change professions; or find innovative ways to work around or eliminate the aspects of their work that make it unbearable. 

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Posted by Sonya Collins on Nov 25, 2014 10:50 AM EST
Members of PCP's University of Rochester chapter value interprofessional collaboration and respect. Every year they host a unique event that fosters relationship-building among medical and nursing students. Here, one of their chapter leaders tells us how it went.

By Julia Cooper

One recent rainy evening, University of Rochester students gathered in a classroom at the School of Nursing for our Primary Care Progress chapter’s Meet-and-Eat event. This annual dinner brings together medical and nursing students to socialize, share stories and enjoy sandwiches from our favorite family-owned restaurant. We love the Meet-and-Eat because our discussions always generate new topics for workshops and talks, but more importantly, because it reminds us that however isolated we may feel, our two schools are only a few steps apart.

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Posted by Sonya Collins on Nov 20, 2014 1:51 PM EST
The 2014 Hotspotting Mini-Grant Project gives health professional students an unprecedented hands-on opportunity to practice an innovative model of care delivery called hotspotting. Hotspotters identify health care super-utilizers --  people who are admitted to the hospital multiple times a year, frequently for avoidable complications of chronic conditions, and who often have social barriers to adhering to their care plan. The hotspotters proactively bring additional attention, follow-up, resources and care to these patients in their homes and communities to help keep them out of the hospital. Student hotspotters will share their experiences here twice a month for the rest of this year in “Notes from the Hotspotters.”

By Eliza Hutchinson

“There was one time when I wasn’t here for seven months in a row,” “Pam” told me.
 
I sat with Pam in her third floor hospital room – the floor on which she always stays when admitted to the inpatient medicine service – as nurses, doctors, and janitors poked their heads in the door to say friendly hellos and “Nice to see you again, Pam!” A dining facility staff member entered with a tray, letting Pam know, “I brought you the usual, Pam. I missed you!” Pam smiled and joked with the parade of staff members as I pondered this oddly happy reunion. 

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Posted by Sonya Collins on Nov 18, 2014 12:18 PM EST
Initially daunted by the complexity of her first primary care patient, this resident went on to build a relationship with him that reaffirmed her decision to practice primary care.

By Eunice Yu, M.D.

When I started my internal medicine residency, I was pretty sure I was going to rock this primary care thing. I knew the drugs for hypertension, the guidelines for diabetes management, and depression management seemed like nothing more than an algorithm. I felt buoyed by familiarity as I looked at the problem list for my first primary care patient: basically diabetes, hypertension, and depression.
 
As I opened the exam room door that early July day, I smelled the urine from my patient’s catheter before I even saw him. He sat in a motorized wheelchair, one leg amputated, and he didn’t make eye contact.

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Posted by Sonya Collins on Nov 13, 2014 10:06 AM EST
The third annual Gregg Stracks Leadership Summit equipped future primary care providers with leadership skills they'll apply in many settings.

By Sonya Collins

For nearly a decade, transformation and reform have been dominant themes in health care. Primary Care Progress (PCP) wants to prepare the next generation of primary care providers to help lead that transformation. As part of that mission, the grassroots organization hosted its third annual Gregg Stracks Leadership Summit this September at the Microsoft New England Research and Development (NERD) Center in Cambridge, MA. The summit brought together 67 PCP chapter leaders and six faculty advisors from four health care professions and 22 institutions around the country. 

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Posted by Sonya Collins on Nov 11, 2014 11:09 AM EST
Next week, Harvard Medical School's Primary Care Student Leadership Committee will host theSymposium on Mass Incarceration and Health: Advocacy in Medicine and Beyond.” The event will bring together physicians, patients, and advocates to discuss correctional health needs (details below). Here, medical student Tamara Rodriguez Reichberg describes the disparities in the health care and health outcomes of incarcerated people. 

By Tamara Rodriguez Reichberg

“He was beating me. So I set him on fire.”

This was the first thing Sharon told me. She was tall and skeletally thin. In the short course of her incarceration, her HIV had progressed to AIDS, and she died within months. At the time of her death, a request form for medication services, filed the day she entered prison, sat unprocessed in a stack of papers somewhere in the bureaucratic offices of Massachusetts’ Suffolk County House of Corrections.  

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Posted by Sonya Collins on Nov 6, 2014 11:40 AM EST
The 2014 Hotspotting Mini-Grant Project gives health professional students an unprecedented hands-on opportunity to practice an innovative model of care delivery called hotspotting. Hotspotters identify health care super-utilizers --  people who are admitted to the hospital multiple times a year, frequently for avoidable complications of chronic conditions, and who often have social barriers to adhering to their care plan. The hotspotters proactively bring additional attention, follow-up, resources and care to these patients in their homes and communities to help keep them out of the hospital. Student hotspotters will share their experiences here twice a month for the rest of this year in “Notes from the Hotspotters.”

By Tricia Olaes

I excitedly opened my new email account inbox and saw the first list of potential patients to recruit. All were just names on an automated Excel spreadsheet, and I wondered which one of these individuals, strangers to me now, would be our hotspotting team’s first recruited patient. Our teamwork had already served us well, and here we were, finally beginning.

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Posted by Sonya Collins on Nov 4, 2014 9:35 AM EST
In today's post, family physician and regular Progress Notes contributor Andrew Selinger details the many changes currently underway in health care and primary care.

By H. Andrew Selinger, M.D.

As a family physician struggling to practice according to the new paradigm of population health management, I am stretched to the limit of my comfort zone. When I graduated from the University of Pennsylvania  School of Medicine in 1983, the overarching goal was to learn as much as I could in my chosen field of practice, pay close attention to my patients’ clinical histories, examine them thoroughly and order whatever tests (taking advantage of emerging technologies) would  provide me with the necessary information to effectively address their complaint(s). I was then expected to prescribe the recommended treatment(s) from the growing choice of medications and therapies available. The expectation for our profession was that we would keep up with the literature to always provide our patients with the most current health care treatment recommendations. At the time, this was truly patient-centered medical care. 

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Posted by Sonya Collins on Oct 30, 2014 1:31 PM EDT
Last month, PCP chapter leaders from around the country met in Cambridge, MA, for the third annual Gregg Stracks Leadership Summit. They shared stories of the challenges of pursuing a career in primary care in an educational system and in a health care system that usually don't value that choice. They learned community organizing skills that will help them harness the passion and talents of fellow primary care advocates across professions to raise the profile of primary care on their campuses and in the health care system. In the coming weeks, we will read stories by summit participants. Here's one of them.

By Catherine "Katie" Derington

Having never been to a conference before, I didn’t have many expectations before PCP’s third annual Gregg Stracks Leadership Summit. I just hoped to learn a lot, get inspired, and have fun. Specifically, I wanted to learn about how to grow as a leader, inspire others, work more effectively in teams, and handle conflict with those who may not share my vision.
 
My list of apprehensions, however, was longer than my list of expectations: being in a new city, catching flights, icebreaker activities, appearing like a naïve student, making good impressions, not being taken seriously as a student, studying for the multitude of quizzes I had the next week, and finding time to sleep.
 
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Posted by Sonya Collins on Oct 28, 2014 11:35 AM EDT
Last month, PCP chapter leaders from around the country met in Cambridge, MA, for the third annual Gregg Stracks Leadership Summit. They shared stories of the challenges of pursuing a career in primary care in an educational system and in a health care system that usually don't value that choice. They learned community organizing skills that will help them harness the passion and talents of fellow primary care advocates across professions to raise the profile of primary care on their campuses and in the health care system. In the coming weeks, we will read stories by summit participants. Here's one of them.

By Rebecca Sedillo, F.N.P.

On my first day of a clinical rotation at a community health clinic in Phoenix, AZ, nursing students, med students, interpreters, and primary care providers huddle in the back room to present history and physical exam findings to our M.D. preceptors. In between patients, one of the med students starts chatting me up. “You’re a nurse practitioner student? Cool, my mom is a nurse. Wait, what’s the difference between a nurse and a nurse practitioner?”

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Posted by Sonya Collins on Oct 23, 2014 10:31 AM EDT
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First-person stories from the front lines of primary care.

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Most Recent Comments

I really enjoyed reading this reflection on your time in the hot spotting cohort, Eliza! It is really interesting to...
Eunice, thanks for sharing this post. You and your patient sound lucky to have found each other. Thanks for remindin...
What an inspirational post! The leadership time is such a spectacular opportunity to gain leadership skills for ad...
What an important piece! It seems crucial that as human beings, and especially as physicians, we never become indif...
Thanks Tamara for sharing your personal experiences that bring to life this devastating issue. It seems that crimi...

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