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PCP Notes From The Field: How To Create Local Change

April 28, 2011

By Andrew Morris-Singer, MD

Recently, I was on the phone with a 2nd year medical student who leads his medical school’s primary care student interest group. As we chatted, he recounted all of the fantastic stuff his group had accomplished over the year: a panel discussion of primary care providers, a talk by a local clinician-innovator, and a regular primary care policy journal-club. As always, I was blown away by his energy and commitment to making a difference in primary care while being a full-time medical student.

Despite all of his group’s successes, he confided to me that he felt something was missing.

“We’re just catering to med students right now, but honestly, I know a lot of faculty who would get a lot out of this as well, and it would be really tremendous for us to have a chance to connect with more of them in the process. We need to meet inspiring mentors right now and frankly,” he said, lowering his voice, “some of these primary care clinicians can clearly use a little ‘feel good’ themselves.”

I agree with him 100%. Regardless of the specific primary care field we work or train in, many of us have personal and professional needs related to primary care that are currently unfulfilled: students who want to find inspiring primary care mentors; clinicians who feels isolated and overworked, frustrated that no trainees seem to be following in their footsteps; and primary care trainees who seek increased exposure to new models of care during training.

Sounds familiar, right?  What might also sound familiar is the refrain that none of these challenges can be solved without first enacting reimbursement reform. But this refrain does us a disservice because all of the above examples revolve around local circumstances: actions or inactions, by members of the local primary care community, that create an environment that is more or less healthy when it comes to recruiting the next generation of primary care providers and preparing them to be successful.

To be sure, payment disparities between primary care providers and our specialist colleagues play an important role. But think about that student who’s curious about a career in family medicine. What would be more influential for her? Finding out that there are now five primary care clinicians on the committee that assigns values to physician services as opposed to two, or getting her hands on a list of the local family medicine providers who are excited to mentor students?

Likewise, in the case of the resident who’s trying to decide between primary care and hospitalist medicine, what would have a greater impact? Finding out that the new health law increases payments to primary care providers by 10% or having a local clinician innovator provide her an opportunity to observe a Patient Centered Medical Home and witness firsthand how the field is reinventing itself?

At Primary Care Progress, we believe that many of these local challenges can only be remedied through local actions and activities, and we’re here to help make it happen.

Organizers of PCP’s Bryn Mawr chapter, made up of post-baccalaureate pre-medical students, recently planned a panel discussion in which inspiring primary care providers talked to students about their careers and the future of the medical home model. They made sure that students in the audience voiced their own interest in primary care careers at the same time. The result? The event was just as inspiring for the assembled faculty as it was for the students.

“At the end of the event, I had faculty approaching me, noting that this was one of the most energizing things they’d been involved in for some time,” the event organizer told me.

When I checked in with him a month later, he noted that many of those same faculty members were now actively mentoring some of his colleagues. One of them has rejoined the chapter’s efforts to organize a “medicine speaks to the arts” panel geared toward improving care and communication for the Philadelphia arts community. Sounds like a win-win for all involved.

So in your quest to create positive change on behalf of our primary care system, remember to think (and act) locally as well as globally, as there are innumerable opportunities to make a concrete difference that demand local action. Like the Bryn Mawr chapter, you can fulfill a number of groups’ unique desires at the same time.

 

Andrew Morris-Singer is the president of Primary Care Progress and a primary care doctor atBrigham and Women’s Hospital in Boston.  Prior to medical school, he worked as a community organizer and issue campaign trainer.

Stay tuned for the next in our How To series on tools and strategies for engaging our local primary care communities to effect change.

Posted by SWL Admin on Apr 28, 2011 1:00 AM America/New_York
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