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EHR's have been a long time coming. This family physician first used one in residency in the 70s, but the uptake has been a lot slower than he expected. 

By Charles Sneiderman, M.D., Ph.D.

Throughout my entire career as a family physician, I have been a proponent of electronic health records. I was first introduced to both the amazing ability of computers to perform complex logical operations and the frustration of programming even the simplest of these operations during graduate school in the early 1970s. The family medicine residency at the Medical University of South Carolina used the COSTAR system (Computer Stored Ambulatory Record) developed at Harvard University, and I was convinced that I could not practice properly without such a tool. 

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Posted by Sonya Collins on Jul 23, 2015 12:53 PM EDT
We launched our 50th chapter this summer! To celebrate, we're highlighting activities of all our chapters throughout the summer. It's the PCP Chapters of Summer campaign. Today on the blog, read about the kick-off and goals of our 50th chapter. 

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. 

 Our mission is to promote interdisciplinary collaboration, mentorship and community outreach in primary care throughout the Hawaiian Islands. In doing so, we hope to strengthen the primary care network across the Hawaiian Islands. In the short-term, we plan to designate an ambassador for each health care school; build our membership to 50 people; organize and hold a kickoff event; and have at least four events during the 2015-2016 school year.

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Posted by Sonya Collins on Jul 21, 2015 9:32 AM EDT
We launched our 50th chapter this summer! To celebrate, we're highlighting activities of all our chapters throughout the summer. It's the PCP Chapters of Summer campaign. Today on the blog, read about a chapter event that encouraged students of various health care disciplines to get to know each other...then try it with your own chapter!

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.

Here’s how it works: After dinner, medical and nursing students sit facing one another around a ring of tables. One group shifts by one seat every few minutes, speed-dating style. On the tables, we put out question cards prompting students to compare their training programs, career goals and visions for interprofessional cooperation. The Meet-and-Eat is a safe space for students to ask questions about health care professions other than their own and to begin exploring the intersections of their different roles. We also ask students to reflect on interprofessional communication, both good and bad, that they have observed. We try to emphasize the goals that unite us — our passion for patient care and our hopes for the U.S. health care system. We then come together for a group discussion, which helps us to process what we’ve learned and set educational and advocacy goals for the coming year.

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Posted by Sonya Collins on Jul 16, 2015 11:10 AM EDT
While summer means vacation for many, it's a crucial time of transition for those in medical education. Medical students rise into the next year of their education and newly minted physicians start residency. Today, in a piece from our archives, two former primary care interns offer words of wisdom and encouragement to those moving into the role.

By Alicia Carrasco, M.D. (right), and Lekshmi Santhosh, M.D. 

A few of us got together last week to reminisce about intern year. Not in an “I’d love to do that again” kind of way, but more in an “at least it didn’t kill us” style. Could anything have prevented the nights of tossing and turning, hoping our decisions and ignorance weren’t going to kill our patients?  Or the cracking voice and cold sweats prior to presenting on rounds?  Was staying until 11pm finishing notes after clinic inevitable? Did any of us make it through a call day without becoming more dehydrated than our patients?  At the end of the day, intern year is full of challenges, but also extremely rewarding, and ultimately, you will look back on it fondly as the time when you were the patient’s main doctor among the sea of residents, attendings, and subspecialty consultants. There is nothing we can say or do to make intern year easy, but we polled our fellow UCSF internal medicine residents to see what advice they had on softening the blow. So, in no particular order, here are some words of encouragement and pearls of wisdom for new interns.

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Posted by Sonya Collins on Jul 14, 2015 2:20 PM EDT
Leaders of several PCP chapters had a unique opportunity to get intensive advocacy training this year through PCP's advocacy cohort. Today on the blog, a cohort member from Stanford's PCP chapter talks about her experience. 

By Victoria Boggiano

At the outset of my second year of medical school, I was still trying to figure out what I wanted to bring to my future career in medicine. But I knew primary care was my calling. That was when I attended the Gregg Stracks Leadership Summit hosted by Primary Care Progress in Cambridge, Massachusetts. I was blown away by all we learned at the summit about organizing other students on our campuses to support primary care. We discovered the art of storytelling — using our personal narrative about why we support primary care to encourage others to think about their own stories around medicine and health. We also brainstormed projects our individual chapters could take on with the help of PCP national. I left the conference feeling motivated to advocate for primary care, but I was also a little uncertain how to put our new ideas into action. 


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Posted by Sonya Collins on Jul 9, 2015 12:22 PM EDT
While summer means vacation for many, it's a crucial time of transition for those in medical education. Medical students rise into the next year of their education and newly minted physicians start residency. Today, in a piece from our archives, Dr. Kyle Bradford Jones offers words of wisdom and encouragement to incoming residents.

By Kyle Bradford Jones, M.D.

Nearly twelve years ago, Major League Baseball’s Cleveland Indians were losing to the Seattle Mariners 14-2 in the sixth inning. Cleveland, who were fighting off the resurgent Minnesota Twins and the pesky Chicago White Sox in a tight division race, were playing against a Mariners team that would finish the season tied for the most wins ever in a single season. Despite the seemingly insurmountable lead, Cleveland came back to win 15-14, making what has come to be known as The Impossible Return. This win ended up propelling them forward to an eventual division title.

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Posted by Sonya Collins on Jul 7, 2015 8:57 AM EDT
Only a quarter of American medical schools offer the 25 hours of nutrition training recommended by the National Academy of Sciences, NPR news reported yesterday. Yet, what we eat is the most important factor in preventing early death and chronic disease. Today on the blog, we'll see what some med students at Baylor College of Medicine did to get the nutrition training they needed.

By Amy Cobb, M.D. 

When I saw that Mr. Jones was in for yet another exacerbation of his chronic congestive heart failure, I felt utterly exasperated. I approached his bedside to find out what had gone wrong in the few weeks since his last hospitalization when I saw them. They were unmistakable and all too familiar. Red, freshly polished, and clownishly big, two shoes were peeking out from underneath the bedside curtain. Sniff, sniff. If the shoes hadn’t given him away, the smell would have. I gathered whatever patience and calm I could muster and pulled back the curtain. To no surprise (but to much dismay), Ronald McDonald was sitting there by my 47 year-old obese, hypertensive, diabetic patient, serving him an over-sized Big Mac and fries.

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Posted by Sonya Collins on Jul 2, 2015 9:12 AM EDT
We're excited to be planning our fourth annual Gregg Stracks Leadership Summit. Today on the blog, you'll meet Krisda, one of our summit coaches. He wrote this post after he attended the summit for the first time in 2013. This year he will return for the second time as a coach. Hope to see you at the summit!

By Krisda Chaiyachati, M.D.

I had been back on US soil after a six-week rotation in South Africa for barely a week before attending the 2013 Gregg Stracks Leadership Summit in Boston. The night before, my wife Barbara asked, “Remind me why you’re going to this?” I glossed over a few catch phrases about primary care and leadership, but she surely could tell I wasn’t convinced. more...
Posted by Sonya Collins on Jun 30, 2015 10:32 AM EDT
Saturday, June 27, is National HIV Testing Day. Today on the blog, we revisit a post from our archives about the current state of HIV care in the U.S. As HIV is no longer an acute crisis and instead a lifelong chronic disease, care needs for HIV+ people have changed. Here, the writer discusses the need for ongoing primary care for aging HIV+ people.

By Andrew Hart, M.P.H.

My interest in HIV is both personal and professional. I am a member of a community that continues to be the hardest hit by the epidemic: gay men. Some of my friends are HIV+ and while the shock and sadness is perhaps less than when the epidemic was nothing short of a nightmare through the 1980s and early 1990s, the struggles they must confront are many and complicated, and will only increase as they age with the disease. Professionally, I’m interested in HIV because I am trained in public health and pursuing my PhD in social policy with an emphasis on health services research and health policy.
 
Mainly because of the success of combination antiretroviral therapy (cART), Americans think all is well with HIV. But that simply isn’t true. HIV has become a disease of the impoverished, so it’s easier to hide. What’s more, those aging with HIV are mostly forgotten – in part because of the “all is well assumption” but also because the elderly in general are mostly forgotten in our culture. By 2015, 50 percent of people diagnosed with HIV or AIDS will be 50 years old or older. The life expectancy of people living with HIV is approaching that of the general population.

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Posted by Sonya Collins on Jun 25, 2015 12:31 PM EDT
At its inception, the direct-pay, retail clinic was an innovative model that expanded access to primary care and made payment a direct transaction between patient and provider. But has it continued to be an alternative to the traditional model? Today on the blog, the founders of Minute Clinic look back on the model they designed more than 15 years ago and discuss the future of retail clinics. 

By Rick Krieger and Doug Smith, M.D.

Retail health clinics, by definition, are when the consumer pays the provider directly at point of sale. It was a model created to compete for the co-pay, the patient’s money, by providing a better care experience.   
 
The original QuickMedx/Minute Clinic model that we created in 1999 was a flat fee $35 for each visit; paid when care was received, and no insurance claim was submitted. This model lowered the cost of care significantly by avoiding the insurance billing. It was a retail sale in the truest sense and a major disruptor as patients came to us knowing exactly what the cost of care was. It was also profitable. 

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Posted by Sonya Collins on Jun 23, 2015 11:22 AM EDT
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Most Recent Comments

Interesting article, Mara! I absolutely agree that the best way to treat a patient is to focus on patient-engagemen...
Such an inspirational post, Sonya! I feel so good after reading this post!
Thank you for sharing!
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...

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