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87662f71c032c50632bb111cc91cc593-huge-leAs team-based models of primary care become more prevalent, you may encounter health care professionals you've never heard of before.  For example, what's a health coach?  Here -- in a post from our archives -- is an explanation from C. Leigh Goldsmith, who was a health coach at Iora Health's Collective Primary Care in Brooklyn, NY.

By C. Leigh Goldsmith

The patient tracking system lights up my laptop with “WAITING.”  I head out to the waiting room to meet “Angela” with a smile and a handshake.  She stands up from the sleek gray couch. Light streams into this magnificent space that is so rare in New York.  Angela has red pixie hair and thick black hipster glasses covering pensive eyes.  She gives me a smile, big but sad. 
Posted by Sonya Collins on May 26, 2016 11:36 AM EDT
adde7675af24249cb43282150ef6d77a-huge-khHere on the blog, we've been taking a closer look at team-based care. This psychology student learned that crucial members of the care team were right outside her door. Here she explains the value of team-based care and integrating behavioral health into primary care. 

By Linda Khatib

I treated “Tina” in an intensive outpatient program for psychological services. She was one of many patients I have treated who struggled with countless comorbid chronic conditions, both physical and mental. Specifically, Tina struggled to cope with bipolar disorder, diabetes and obesity.
Throughout the course of treatment, I tried my best to provide her with the greatest care possible, but I felt helpless because psychological treatment was not enough. I was able to help Tina recognize and acknowledge her maladaptive eating behaviors. We also worked together to gain a better understanding of her addiction to food, which was due to underlying traumatic experiences she faced during her upbringing. Although she was able to reach this pivotal point in therapy, I felt she needed more to see improvements in her overall life. One of her goals was to lose weight and better manage her diet, so I searched for a nutritionist who would see Tina to further address her diet needs and help her choose healthier foods. In addition, the nutritionist could better meet Tina’s needs for managing her diabetes and losing weight. 
Posted by Sonya Collins on May 19, 2016 11:14 AM EDT
47c84d1864ff0bf6a177754787d2de4f-huge-scA family medicine resident learns from her mentor that educating patients is the most important thing a doctor can do. 

By Patricia Martin, D.O.

My mentor recently went on maternity leave after the birth of her second child.  I quickly noticed the absence of her calming presence around our frenetic health center on the west side of Chicago.  I also noticed how in her absence I started to feel a little more overwhelmed by the day-to-day stress of our practice.  I began to reflect on how her presence and guidance had shaped my experience as a family medicine resident thus far.  She had been lighting the path for me, and when she first left, it was as though someone had abruptly turned off the light. 

Posted by Sonya Collins on May 12, 2016 11:17 AM EDT
Emina headshotToday on the blog we begin our celebration of National Nurses Week: May 6-12, 2016. PCP’s Advocacy and Leadership Fellow Emina Bayomy, also a nurse, recalls a clinical experience in her training that showed her the true value of interprofessionalism and the vital ways her profession interacts with the entire health care team.  

By Emina Bayomy

During my experience in nursing school, interprofessionalism was something we were taught in our courses and strived for in our clinical experiences. I was empowered to feel like I was an integral member of the health care team. Unfortunately, as a student it is easy to doubt your abilities due to inexperience. Consequently, you might fail to seek out opportunities to collaborate. It is much easier to be siloed in your own profession’s work. more...
Posted by Nate Leskovic on May 5, 2016 10:35 AM EDT
9d0c66ef9744f9af71c679f3de252cd9-huge-imApril is Occupational Therapy Month, so we invited a few occupational therapists -- including past members of our Hotspotting Learning Collaborative -- to tell us just what occupational therapists do and what that has to do with primary care. Here's what they had to say.

By David Goldstein, Jillian Fader, and Sherry Muir, PhD, OTR/L

April is occupational therapy month, but what’s occupational therapy?

Many of you probably know that occupational therapy is a health care profession that focuses on rehabilitating individuals who have physical impairments and need to regain the ability to complete daily tasks and manage basic needs. Or perhaps, you also know that occupational therapists help children with disabilities in the school system gain the skills needed to participate in school and play.

This is all true, but occupational therapy has a much wider scope than most health care professionals realize.

Posted by Sonya Collins on Apr 28, 2016 10:43 AM EDT
25e1a3cb22e651c634b769ac0b9f8880-huge-e7For the next few weeks, Progress Notes will take a look at team-based care. What do providers think about it? How do patients feel about it? In this post from our archives, a doctor explains how patient engagement is crucial to the success of team-based care.

By Sarah Smithson, M.D.

Last week, I had a follow-up visit with one of my most energetic patients. She has truly embraced our new medical practice, Carolina Advanced Health, a patient-centered medical home that emphasizes prevention and management of chronic diseases through a multidisciplinary team-based approach. With the help of our nutritionist, in the last six months she has shed over ten pounds from her petite frame through changes in her nutrition and exercise. Her blood pressure, once borderline, is now within goal. The same is true of her blood sugar and cholesterol – her LDL dropped over 50 points without medication. Her energy fills the exam room, and she is eager to help other patients share in her success. We brainstorm together.
Posted by Sonya Collins on Apr 21, 2016 1:59 PM EDT
5da32ab51a2430ab7a2740b0f60d7890-huge-m_For the next few weeks, Progress Notes will take a look at team-based care. What do providers think about it? How do patients feel about it? Today we hear from a doc who says clinical innovation and team-based care could dramatically change the answer to the most common patient question: When do I need to come back to see you? We not only need means of reimbursement for these models; we need to train the next generation of health care professionals to practice in these models. This post first appeared on Progress Notes in 2013 after it was published on Colorado Coalition for the Medically Underserved's blog.

By Mark Earnest, M.D., Ph.D.

“When do I need to come back and see you?”  Jane asks.

Her simple question is probably the most common question a doctor has to answer.  It comes up in literally every patient encounter. She asked it as we finished discussing the possible side effect of the new medication she will start to control her blood pressure. Like most doctors, I devoted little thought to her query and answered according to my habit and training, but her question deserves a lot more thought. How doctors like me answer this question may be the key to improving access to care and solving the looming doctor shortage. more...
Posted by Sonya Collins on Apr 14, 2016 11:36 AM EDT
6df1d7795e6b2c8f89f56831c56a914a-huge-brIt's National Public Health Week. In his editorial that originally appeared on The Huffington Post, Brian Castrucci explains why team-based care must include the public health department if it is to address social determinants of health.

By Brian Castrucci

There is increasing talk about moving "upstream" – working to prevent disease before it happens by addressing the social and environmental determinants of health – to improve health and reduce costs.

Among the champions of this approach is Rishi Manchanda, M.D. In his TED book, The Upstream Doctors, Manchanda argues for more "upstreamists" -- physicians who see their work as including a "duty not only to prescribe a clinical remedy but to tackle sickness at its source."

As an example, Manchanda recounts the story of a patient, Veronica, who suffered from severe chronic headaches. Her interaction with the health care system had resulted in inconclusive medical tests and an expensive visit to the emergency room, but no answers as to the cause of her headaches, let alone a solution.

Posted by Sonya Collins on Apr 6, 2016 11:10 PM EDT
6f93abcabb876160ec550bfd5d4ee48d-huge-joIn honor of Social Work Month, we're reposting this piece from our archives written by a social worker looking at primary care as total responsibility—not only for the physical health of the patient, but for the betterment of their life.

By Joe Tobias

Earlier this year I heard Jack Geiger deliver Grand Rounds in the Social Medicine Department of Montefiore Medical Center. A physician well into his 80s, Geiger still travels the country promoting medicine as social rehabilitation—a model he has championed for the past fifty years. In the Mississippi Delta, in the racially divided South of the 1960s, Geiger started the nation’s first community health center. Not only did the center treat North Bolivar County residents’ acute medical problems, it also empowered them to lead better lives: to learn the skills they needed to stay healthy, to obtain the education that poverty had unjustly denied them and to realize their potential.
Posted by Nate Leskovic on Mar 31, 2016 12:58 PM EDT
6f067015fcfe71c26f5f06b99a3c547a-huge-54Last week, you read about the experiences of medical and pharmacy students who applied for this year's Match. Here on Progress Notes, we've covered The Match for many years, and we've seen that many factors go into students' choices for where they'd like to match. Here's a list of ten of the most common factors Progress Notes contributors say that they looked for in a residency.
Posted by Sonya Collins on Mar 22, 2016 1:08 PM EDT
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Am here to testify of the miraculous work of a great traditional doctor called DR.BOADI. i have not come here to tell lies but am here to give hope to the hopeless, those who are suffering from deadly disease such as HIV, CANCER, HEPATITIS and lots more. i was once a victim of HIV ( with CD4 COUNT OF 220) which i contacted from my deceased husban...
This looks intresting one and thanks for sharing. Any decision patient only input ant output important.
Thank you for sharing such ideas...
Thanks for the full summary of events and new leadership directions we need to take in primary care. Student and resident leadership is vital to the future of primary care, especially Family Medicine, where many of our senior leaders are shifting into health system, regional, state and federal roles, thus creating large need for new and emerging leader...
I very much agree with Andrew's take home lessons. As someone based at another major medical school and academic health center, it has been inspiring to witness the effective mobilization among students, residents and allies to revive the Columbia FM residency program. It requires sustained effort to ensure that a victory like this translates into re...

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