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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 Meg Lagunas

I had a 17-year-old brother with Prader-Willi Syndrome who required the care of numerous specialists.  Each specialist was individually an great health care provider who worked hard to give the best care possible to my brother and family, but each of these specialists only worked within their own specialty, their own body system, their own silo. 

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Posted by Sonya Collins on Oct 21, 2014 11:56 AM EDT
This family doc highlights the ways in which Medicare's payment for graduate medical education doesn't guarantee the country gets the types of doctors it needs.

By Kenny Lin, M.D.

The Institute of Medicine released a report in July that recommended significant changes to the way Graduate Medical Education (GME) is financed. The report, “Graduate Medical Education That Meets the Nation’s Health Needs,” is by a 21-member expert committee formed to conduct an independent review of the governance and financing of the system. The report “provides an initial roadmap for reforming the Medicare GME payment system and building an infrastructure that can drive more strategic investment in the nation's physician workforce,” including accountability requirements for institutions to meet workforce needs, particularly primary care graduates.

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Posted by Sonya Collins on Oct 16, 2014 10:17 AM EDT
PCP's annual Gregg Stracks Leadership Summit gives participants the opportunity to plan advocacy events and campaigns on their campuses. Harvard Medical School chapter members took the opportunity to plan the outreach strategy for their upcoming event -- a town hall that boldly asks the question, "What would the future of Harvard Medical School look like with family medicine?"

By Andreas Mitchell

In less than a month, Harvard is hosting an unprecedented event called “What Would the Future of Harvard Medical School Look Like with Family Medicine?" I am excited to see my school – which has no family medicine clerkship, department, or residency program – open up a dialogue about the possibilities for family medicine at a university that strives to lead health care reform efforts. 

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Posted by Sonya Collins on Oct 14, 2014 11:01 AM EDT
In honor of National Primary Care Week 2014, we're running blog posts all week that recognize underserved and marginalized communities and the primary care providers that serve them. 

By Anthony Fleg, M.D., M.P.H.

From the second Tim came into the emergency room, he was labeled “alcoholic.” Tim had had two alcohol-related hospital admissions in the last month. As a family medicine intern, I should have looked deeper, but admittedly, I, too, defined him by his addiction. On the night before leaving the hospital this third time, he asked the nurses if he could borrow a pen. He worked all night using a scrap of paper to draw up his vision of wellness and sobriety. And as he walked out of the hospital the next day, he handed me the drawing (below), letting me know that "artist" is the trait he would prefer to be known by, should he come to our hospital again.

The experience had a profound influence on me. Why hadn’t any of us, in the span of three hospitalizations, realized that Tim had a set of strengths that, if identified, would be more important to his recovery than our endless lectures on liver damage or AA meetings? Why had no one asked him what he dreamed of doing instead of living from drink to drink? 

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Posted by Sonya Collins on Oct 9, 2014 10:46 AM EDT
In honor of National Primary Care Week 2014, we're running blog posts all week that recognize underserved and marginalized communities and the primary care providers that serve them. 

By Kohar Jones, M.D.

Here’s a central difficulty of the Affordable Care Act: If everyone has access to health insurance, then everyone has access to all the medical care they need. Curing sickness and preventing death cost a lot, and our country can go broke in the process. We save money and lives when everyone sees a primary care doctor who works to keep people well. But we don’t and won’t have enough primary care providers in the United States to meet the needs of all those who now have access. We’re already facing a shortage. The Affordable Care Act is only going to make it worse.

Many people, including me, are thinking about how to build the future health care workforce that we need to keep Americans healthy. How do we train more primary care providers? How do we encourage them to work in the communities where their services are needed most?

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Posted by Sonya Collins on Oct 7, 2014 9:39 AM EDT
This year National Primary Care Week honors advocacy for marginalized and underserved communities. We're kicking off the week by telling you about the 2014 Hotspotting Mini-Grant Project, a program that helps students care for underserved patients in their community in an innovative way. 

By Sonya Collins

This summer marked the launch of the 2014 Hotspotting Mini-Grant Project. The initiative, a collaboration between Camden Coalition of Healthcare Providers (CCHP), the Association of American Medical Colleges (AAMC), and Primary Care Progress (PCP), gives health professional students an unprecedented hands-on opportunity to learn and practice an innovative model of health care delivery called hotspotting.
 
Hotspotting, developed for use in health care by family physician Jeffrey Brenner (top left) of CCHP, identifies health care super-utilizers and invests more time and resources in them in order to keep them out of the hospital. Brenner was inspired by the method former NYPD Commissioner William Bratton devised to cut crime in New York City. He focused more resources in the areas that had heavier crime. 

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Posted by Sonya Collins on Oct 6, 2014 10:52 AM EDT
Participants in PCP's 3rd annual Gregg Stracks Leadership Summit in Cambridge, MA, last weekend got to hear a panel discussion on building coalitions to transform primary care. Health care system innovator Jeff Brenner skyped in to join the panel. If you missed it, you've got to see what this family doc is all about! Here's a story about him from our archives.

By Sonya Collins 

“You’re too smart for primary care.” Every primary care provider-in-training has heard it before. But Jeffrey Brenner, a family physician in Camden, NJ, has just proven that there is no ceiling for intellect in this profession. He’s been named a “genius.”
 
Last month [September 2013], the 44-year-old founder and executive director of Camden Coalition of Healthcare Providers won a prestigious MacArthur Fellowship, also known as “The Genius Grant,” in the amount of $625,000 that he can spend however he pleases. The award is recognition for his innovative “hotspotting” model of care, which identifies the sickest and most expensive patients in the health care system and makes targeted interventions in order to stop medical complications before they occur to avoid unnecessary ER visits and hospital admissions and drastically lower health care costs.  more...
Posted by Sonya Collins on Oct 2, 2014 11:23 AM EDT
In this piece from our archives, the writer shares the patient perspective on having a resident as a primary care provider.

By Susan Putnins

“I’ve been with my doctor for years and years,” an elderly man, voice hoarse but lilting with fondness for his caregiver, told a nurse in the primary care clinic where I was waiting to see a doctor. “He’s fantastic.”

I was coming to the clinic for a follow-up appointment about an injury for which I’d been seen a few months prior, but neither the initial appointment nor this follow-up were with my primary care doctor. In fact, I hadn’t been able to see my own doctor for any issue for months – and I’d recently learned that I might never again. I found myself feeling jealous of this man’s relationship with his doctor.
 

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Posted by Sonya Collins on Sep 30, 2014 12:39 PM EDT
We can hardly believe that PCP's 3rd annual Gregg Stracks Leadership Summit kicks off tomorrow night! Here's a throwback to the 2012 summit. #TBT #PCPSummit2012 #PCPSummit2014

By Joe Nelson, M.D.

When I got on the plane headed for the Greg Stracks Leadership Summit last year, I was skeptical. I'd recently been wondering if this Primary Care Progress thing was really for me. I believed in its principles, and enjoyed the time I'd spent with its leaders, but sometimes I wasn't sure that this was my fight. And with three young children and the demands of third-year clinical rotations, I was more often exhausted than excited to do more. But I told myself that even if the conference wasn't anything special, and even if I didn't have what it took to help lead PCP at Baylor, it isn't often that someone offers to fly you to Boston in the fall. So I went.

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Posted by Sonya Collins on Sep 25, 2014 11:41 AM EDT
PCP's 3rd annual Gregg Stracks Leadership Summit is just a few days away.  In today's Progress Notes, PCP's president tells the story of Gregg Stracks and why the summit is named for him.

By Andrew Morris-Singer, M.D.

My junior year of Internal Medicine residency was a difficult, confusing time. A trainee committed to a career in outpatient primary care, I found myself spending a great deal of time on inpatient hospital wards with some of the sickest, most complicated patients I’ve ever encountered. While the medical conditions were fascinating, most were preventable exacerbations of chronic problems or late outcomes of diseases that could have been caught earlier with screening. It felt like we were perpetuating a failed health care system that did little to manage and protect patients’ health but rather waited until they got really sick, and then dumped everything we had in our medical armamentarium on them. It seemed divorced from good economic sense and completely at odds with both the skills that I wanted to learn to keep patients out of the hospital and the values that brought me into health care in the first place.

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Posted by Sonya Collins on Sep 23, 2014 10:27 AM EDT
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Most Recent Comments

The work that Harvard students and faculty are doing right now is inspiring! I will do my best to be there and stand in s...
Great job! This initiative is truly inspiring and a great project for others to consider around the country. Your ef...
Andreas, this is a great post, about such an important topic! I commend you on your work towards family medicine at Ha...
What a piece! It's really helpful to have Kenny Lin tie the national conversation to institutional realities. With...
Thanks for the kind words. Kylia, yes it is important for physicians to "take care of themselves." You can't do your j...

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