To many practitioners, managers and patients, US primary care is in crisis. Primary care physicians are often overworked and undervalued, and both patients and care providers can feel locked into structures that lack compassion and are unfit for their intended purposes. Healthcare reforms aim to resolve the situation, but changes may take years to deliver and are contingent on numerous outside factors. What steps are within care providers’ power to take now?
This book lays out a course to deliver compassionate care, quality, and efficiency that – unlike many current patient-centred medical home initiatives in the US – does not require outside funding. After reflecting on avoidable problems and harms in primary care, the book offers stories of hope from innovative clinicians across the US before presenting ten practical, deliverable steps to lift primary care provision from ‘poor’ or ‘mediocre’ to ‘great’.
This book will be of interest to practicing family physicians and general internists, but will also be useful reading for health system leaders, healthcare insurance purchasers and insurance company executives.
Avoidable Problems and Harms in Primary Care Practice Introduction Methods
Results Discussion After our study Seven stories I want things back to the way
they were Worried ‘till this day Attentive concern and respect for patient
Prejudice, confusion, and little time Where is the compassion? Runaround and
fragmentation: frustrated with the whole system Insurance controlled care The
heart of medicine The movement toward patient-centered/relationship-centered
medical homes Stories of success Ten steps to a patient-centered medical home
Step one: stop leaving money on the table Step two: team care Step three: rapid
access scheduling Step four: increase panel size Step five: extend hours Step
six: purchase and implement an HER Step seven: start doing population care quality
work Step eight: get a patient portal Step nine: get connected to other clinicians
Step ten: focus on costliest patients Essentials for the journey Readers’
Theater HowsYourHealth Survey
Anton J Kuzel and John D Engel, respectively Professor and Chair of Family Medicine, Virginia Commonwealth University, Richmond, Virginia, USA; Scientific Director, Institute for Professionalism Inquiry, Summa Health System, and Professor Emeritus of Behavioral Science, Northeastern Ohio Universities College of Medicine, USA.
Foreword by David Loxterkamp, M.D., Belfast, Maine