Summit Sponsor Feature: University of Utah Department of Family and Preventive Medicine
Primary Care Progress’ 6th Annual Gregg Stracks Leadership Summit is less than a week away! Today on the blog, we’re featuring one of our major sponsors, the University of Utah Department of Family and Preventive Medicine, and their contributions to our primary care community. Stay tuned for more sponsor Q&As next week, and enjoy Michael K. Magill, M.D.’s response below. Dr. Magill is a professor and holds the Dr. Nymphus Frederick Hicken, Alta Thomas Hicken, and Margarete Stahl Wilkin Hicken Endowed Chair in Family and Preventive Medicine at the University of Utah. He also serves as the Director of the Utah Area Health Education Centers Program. Dr. Magill served as department chair in the Department of Family and Preventive Medicine for 21 years before stepping down in December 2016.
PCP: What makes the University of Utah Department of Family and Preventive Medicine unique among other health professions schools?
Utah: Founded in 1970, the Department of Family and Preventive Medicine at the University of Utah School of Medicine is one of the oldest and most established family medicine departments in the country. Its mission is to optimize quality of life through scholarship that advances health and wellbeing in homes, workplaces, and communities.
In service of our mission to optimize quality of life, the department is much more than family medicine. In addition to an outstanding Family Medicine Residency Program and extensive medical student education, it houses one of the first Physician Assistant programs on the nation, perennially ranked in the top five PA programs, and led in creating this important profession. It also incorporates Public Health and Occupational and Environmental Health programming for hundreds of graduate students. This puts the department at the cutting edge of the transformation of health and healthcare with a synergy between care for populations, communities, and patients.
PCP: What new initiative(s) in your department are you most excited about and how will it affect the primary care community?
Utah: We are very excited about our mission to improve health of individuals, families, and communities. Our teaching, research, and care live in “the sweet spot” where this is happening.
Our medical practices innovate to implement advanced, interprofessional team-based medical homes, focused on the needs of our patients and the continuous improvement of their health. Our care, research, and teaching demonstrate best practices for the future.
Our students, residents, and faculty are leaders. We are proud to have one of the most active, interprofessional PCP teams, with students and faculty from medicine, physician assistant, clinical pharmacy, and other programs. Our Family Medicine Residency Program focuses on preparing great clinician leaders, providing three years of structured training and extensive opportunities leading teams for clinical care and quality improvement. Our Physician Assistant Program is doubling in size to better serve the people of Utah. Our Occupational and Environmental Health group literally “wrote the book” on the best evidence-based practices for workers with musculoskeletal problems.
The impact of our faculty, students, and staff reaches far beyond our school. We partner with state and local health departments, minority organizations, and community leaders to address critical health needs. We house the Utah Area Health Education Centers program, supporting young people in urban and rural underserved communities and helping them become healthcare professionals. We have established a campus in Korea and founded a new School of Public Health in Ghana, both becoming international campuses of the University of Utah. Our research is shared around the world.
In short, this department is a leader in research, education, care, and is laying the foundation for extraordinary primary care that will transform health and healthcare for generations to come.
PCP: As the future of our nation’s healthcare system remains unclear, what is your vision for how providers can use leadership to ensure a healthier future?
Utah: While the details of change are uncertain, of this we are sure: healthcare is transforming to achieve the Quadruple Aim of better care, smarter spending, better health, and sustained, satisfied healthcare teams. This future will be founded on primary care in which interprofessional teams partner with communities to address critical health needs while controlling costs.
In this environment, leadership is more important than ever. But we need leadership that builds collaboration, unleashes the power of diverse disciplines and people, supports caring relationships between team members, patients, and caregivers, and celebrates a passion for service. We need leadership that cares deeply about patients, communities, and colleagues, and understands that together we can thrive and create new systems of care that achieve the Quadruple Aim. We have seen many examples of such leadership emerge in recent years, many inspired by Primary Care Progress. The path is clear. We need to build clinical practices, education, and research programs that accelerate the speed of transformation. It’s not easy, but together we will succeed.
PCP: What are the most promising innovations you anticipate will transform primary care in the coming years?
Utah: There are three: advanced interprofessional, team-based primary care practices that are truly patient-centered, and linked to care of populations and communities. We have many examples of these practices already established across the country. We need more.
Spread of these practices will be advanced by the second innovation: comprehensive pay for primary care. While different models of pay for value are emerging through Medicare and commercial insurance such as patient-centered medical home payments, we believe these are transitional models. Capitated payment for primary care services are the future, and models for this are emerging in direct primary care practices and worksite-based medical homes supported by employers.
The third innovation may take some time to arrive, but when it does it will confirm Winston Churchill’s statement that, “You can always count on Americans to do the right thing – after they’ve tried everything else.” In this case, the “right thing” will be universal health insurance, finally bringing the United States up to standards long recognized by the rest of the industrialized world that facilitate better care, better health, and lower cost of care for the American people through a robust, thriving, and transformed primary care.
PCP: With burnout an ever-increasing factor in healthcare professionals’ lives, what are your thoughts about strategies for reversing the trend?
Utah: Satisfaction for professionals and sustainability of transformed care will come about through two complementary approaches. First, we must change the environment of care. Clinicians and team members are burning out due to a disastrously-antiquated fee-for-service payment model that rewards rescue care but not prevention and health, does not support teams needed for the best care, and drives clinicians into specialties that do not improve overall health. We are burning out due to electronic medical records (EMRs) designed not for care, but to support fee-for-service billing. We are burning out due to quality and financial measurement systems that focus on granular processes of care more than outcomes of importance to health. The good news is that we now have many examples of successful fixes to these problems. But many, many more are needed.
The second approach is more personal, and we must draw on it while also changing our environment. We must support each other in reconnecting to purpose. Even with all the challenges inherent in primary care today, we must continually remind ourselves of the call to service that brought us here in the first place. We must care for each other, and together for our patients, reminding ourselves that the passion we share and the rewards we reap endure well beyond any specific practice organization, payment model, or EMR. And we must continually celebrate the exciting progress underway in transforming care. With this focus, we see great hope for the future of primary care!