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Latest Posts

Dr. David Nace draws a parallel between health care reform today and reforms in the field of aviation in the 1980s.  

By David Nace, M.D.

The Affordable Care Act and health care reform have impacted providers in every way from how they are paid to how they engage patients. To meet the deadlines and demands of an industry shifting to value-based care and succeed in this new world, physicians must change their thinking from independent to team-oriented.

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Posted by Sonya Collins on May 21, 2015 9:17 AM EDT
Working with med students for years, this academic family physician says we shouldn't assume that money is what drives med students away from primary care.

By H. Andrew Selinger, M.D.

During medical school, I struggled to figure out what kind of doctor I wanted to be and what I wanted to do in medicine. Then I went to my first Family Medicine Interest Group (FMIG) meeting. I felt like I had come home. Everything they said, both students and faculty, made perfect sense to me. Family medicine focuses on relationships with patients, identifying their needs and working to meet them. When I was in medical school, this bio-psychosocial model did not exist outside the confines of FMIG meetings. The focus was on breadth of knowledge, stamina, and evolving technologies. I knew family medicine was where I belonged. 
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Posted by Sonya Collins on May 19, 2015 11:38 AM EDT
PCP recently welcomed its 49th chapter: the University of Hawaii. Here, chapter leader Nash Witten tells us about the new chapter's kickoff event and its short- and long-term goals.

By Nash Witten

I went to great lengths to try to attend Primary Care Progress’s leadership summit in San Francisco last January. But attending medical school in Hawaii makes financing and scheduling a Sunday afternoon conference in San Francisco impossible.
 
Though I was disappointed I couldn’t make the conference, one thing was clear: we needed a Primary Care Progress chapter in Hawaii. Within a week of sending an email to medical students at the University of Hawaii John A. Burns School of Medicine about starting a chapter, I heard from 10 students, which included voices from each year in medical school. I was ecstatic. We held our first meeting to develop a mission statement, a long-term goal, and some short-term goals for our fledgling chapter. 

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Posted by Sonya Collins on May 14, 2015 1:32 PM EDT
On the last day of National Nurses' Week, a family nurse practitioner discusses the potential for nurse practitioners to increase access to primary care and the barriers to doing so. 

By Rebecca Sedillo, FNP

It’s a curious time to be a nurse practitioner. Yesterday, I had a conversation with my medical director in the rural family health center in Northern California where I work as a primary care provider.
 
“We’re getting so many impressive nurse practitioners and physician assistants applying to work here, and we need them,” he said. “But the issue is whether we have enough MDs to onboard and supervise them at this clinic.”
 
In California, nurse practitioners do not have authority to practice independently; physicians must supervise us. Supervisory laws can limit the work of nurse practitioners and other non-physician providers. In underserved inner-city and rural areas where physicians in general and primary care doctors in particular are already in short supply, these laws create significant barriers between nurse practitioners and the patients who need our care. 

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Posted by Sonya Collins on May 12, 2015 12:32 PM EDT
In honor of National Nurses Week, today we are running one of our favorite posts by a nurse practitioner from our archives. Alana Rose is a family nurse practitioner. She wrote this piece for us in 2012 when she was a student and apprehensive about how nurses might be received by other health care professionals on the primary care team. 

By Alana Rose, N.P.

I recently attended Primary Care Progress’s Gregg Stracks Leadership Summit. The summit brought together chapter leaders from around the country to get coaching in how to lead our chapters to accomplish our individual goals. 
 
I went to the summit knowing that PCP values teams – the team-based model of organizing to improve the primary care profession and the team-based model of primary care delivery.  In both cases, there would be a place for me, an RN and a nurse practitioner student.

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Posted by Sonya Collins on May 7, 2015 11:53 AM EDT
More than halfway through medical school and on track to follow in the footsteps of the family doctor she admired, this former med student decided she could do more to transform primary care from outside the medical profession. So she left medical school.

By Gina Siddiqui

There he stood at our beach party, the family doctor I grew up admiring. I timidly approached his circle of friends to announce I had gotten into medical school and would start in the fall. He stopped to attention. His friends stood watching. I couldnt conceal my smile. I thought, He is going to be so excited for me!

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Posted by Sonya Collins on May 5, 2015 11:06 AM EDT
This year, more Tufts students matched in family medicine than ever before. One of those students examines the culture at Tufts and around the country that helped make this family medicine win possible. 

By Nathan Macedo

“How did Match Day go,” asks a curious attending with whom I rotated two months ago.
 
The question draws a smile to my face. I matched in family medicine and will be heading to the Greater Lawrence Family Health Center in Lawrence, Massachusetts, to continue on the path to becoming a primary care doctor and working with underserved populations.
 
I share the joy that I have been feeling since that fateful Friday with many of my classmates across specialties, but in a special way with the others joining me in family medicine. This year, a record 25 students, or about 14 percent of my class, matched in family medicine.  Our number is higher than the national average for U.S. fourth-years (8.3%) and higher than any other medical school in Massachusetts.

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Posted by Sonya Collins on Apr 30, 2015 11:32 AM EDT
A group of UMN students weren't deterred when they applied for the Hotspotting Mini-Grant Project last year and weren't accepted. They moved forward with their project anyway. 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 -- and bring additional attention, follow-up, resources and care to these patients in their homes and communities to help keep them out of the hospital. Peter Meyers, one of our clinical innovation fellows, recently interviewed the UMN hotspotters. Here's what he found out.

By Peter Meyers

For the second consecutive year, Primary Care Progress will be co-sponsoring the Student Hotspotting Mini-Grant Project with the American Association of Medical Colleges (AAMC) and the Camden Coalition of Healthcare Providers (CCHP). The 2014 initiative was wildly successful and has been covered thoroughly on Progress Notes and on our hotspotting page

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Posted by Sonya Collins on Apr 28, 2015 11:53 AM EDT
This month on the blog, we're highlighting primary care exemplars. Virginia Tilden is a champion of interprofessional education and team-based care. She represents the values we need in the next generation of primary care delivery. Today, we run a post by Dr. Tilden from our archives.

By Virginia P. Tilden, Ph.D., R.N.

It’s been a long time since I was a baccalaureate nursing student at Georgetown University in Washington, D.C., but my memory is sharp about this fact: nothing in our curriculum taught us to work as an interprofessional team.  In 1967, the year I graduated, nursing was a rigid, rule-based discipline driven as much by hospital policy and faculty dogma as by scientific evidenceAnd, just like medicine, it was siloed by its own knowledge, traditions, and truths.  Even back then it struck me as odd that we nursing students and fellow medical students cared for the same patients when barely a word passed between us. Further, our faculty seemed unaware of each other, as though the two professions operated in parallel universes with almost private and separate languages about the very same patients for whom we jointly cared.

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Posted by Sonya Collins on Apr 23, 2015 11:54 AM EDT
Though they live in a city whose medical community prides itself on innovation, these three young docs felt they were getting no more exposure to primary care innovation than their colleagues in any other city. So they decided to create a primary care innovation elective. 

By Norris Kamo, M.D. (top left); Leah Marcotte, M.D.; and Richard Waters, M.D.

How is it that so many medical students who express an interest in primary care careers before starting residency decide to subspecialize by the time they finish an internal medicine residency?   How many family medicine residents get exposed to diverse models of primary care during their training?  Talking to residents in all of the Seattle family medicine and internal medicine residency programs, we realized that family medicine and internal medicine residents in Seattle weren’t that different from residents elsewhere in the country, even in a city that prides itself on emphasizing primary care, with some of the most innovative primary care practice models in the country. Residents in Seattle programs get almost no exposure to primary care innovation outside of their own institutions.  With a national conversation ongoing about how to enhance prevention and patient-centeredness at the primary care level, exposure to innovation is essential for new physicians.  We wanted to create an opportunity for residents to learn and experience primary care innovation firsthand.

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Posted by Sonya Collins on Apr 21, 2015 12:22 PM EDT
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Most Recent Comments

Thank you for sharing this. Many medical students I know struggle with the family vs. internal medicine (vs. med-pe...
What a compliment to be included in your piece, Dr. Nace. We agree that training as part of a care team is essential for...
Thanks, Nash, for sharing your story of personal initiative and team building. I wish you and your team much luck as y...
Thanks for sharing your story, Gina. Bravo for finding your role in the system, and for your courage to start Remedy!...
Wow, I had no idea that it was so hard for a general physician to enter back into medical practice after being out of it....

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