Improving Primary Care offers frank appraisals and concrete recommendations for primary care practitioners on how to meet the huge, stress-inducing, challenges that they face on a daily basis. The authors offer innovative approaches and suggestions to dealing with primary care issues ranging from the latest electronic technologies to non-traditional options for the patient-physician encounter.
ABOUT THE AUTHORS
- Thomas S. Bodenheimer, MD, MPH, Clinical Professor, Department of Family & Community Medicine, University of California.
- Kevin Grumbach, MD, Professor & Chair, Department of Family & Community Medicine, University of California.
TABLE OF CONTENTS
The Primary Care Home The Primary Care Home
What is Primary Care?
Why Primary Care?
The Value of a Primary Care Home
The Endangered Primary Care Home
Can Primary Care Fulfill its Vision?
Putting the Primary Care House in Order
A New Practice Model for Primary Care Building the New Practice Model
Is the New Practice Model Feasible?
Patient-Centered Care: Finding the Balance What is Patient-Centered Care?
Patient-Centered Care in the Patient-Clinician Encounter
Patient-Centered Care in the Primary Care Microsystem
Patient-Centered Care in the Health Care Macrosystem
Patient-Centered Care Meets Cultural Competence
Barriers to Patient-Centered Care
Conclusion: Patient-Centered Care is a Partnership
Improving Primary Care for Patients with Chronic Illness The Chronic Care Model
Implementing the Chronic Care Model
Do Chronic Care Model Components Improve Clinical Outcomes?
Does the Chronic Care Model Save Money?
Changing Primary Care to Incorporate the Chronic Care Model
Self-Management Support for People with Chronic Illness Traditional Versus Collaborative Relationships
Implementing Self-management Support in Clinical Practice: the 5 A?s
Improving Timely Access to Primary Care Three Access Models for Primary Care
Case Studies of Advanced Access
Research on Advanced Access
How to Begin
Alternatives to the 15-minute Visit Group Visits
Computerizing the Primary Care Home The Roles of Electronic Health Care
Techies and Luddites
The Benefits of Computerization
Health Care Teams in Primary Care Groups and Teams
A Brief History of Primary Care Teams in the United States
Two Contemporary Primary Care Teams
Research Studies on Primary Care Teams
The Problems with Teams
Introducing Teams into Primary Care
Diagnosing and Treating the Primary Care Practice What is a Microsystem?
Diagnosing the Primary Care Microsystem
Treating the Primary Care Microsystem
Payment for Primary Care The Primary Care Specialty Income Gap
The Key Role of Volume
Fee-for-Service Payment and the New Practice Model
What Could be done to Change the Situation?
APPENDIX A Some Organizations and Resources Demonstrating Innovative Primary Care Practices
APPENDIX B Assessing your Practice
APPENDIX C Diagnosing Problems in your Practice
APPENDIX D Primary Care Patient Survey
APPENDIX E Primary Care Staff Satisfaction Survey
APPENDIX F Resources on Cultural Competence Health Literacy
APPENDIX G Office Visit Cycle Time
APPENDIX H Interruptions in the Day?s Work
APPENDIX I Group Visit Starter Kit
APPENDIX J Resources Available from Improving Chronic Illness Care
APPENDIX K Patient Assessment of Chronic Care
APPENDIX L Self-management Support Tools
APPENDIX M Self-management Support Assessment
APPENDIX N Review of Evidence on the Chronic Care Model
APPENDIX O Review