Increasing the supply of primary care physicians is necessary, but not sufficient, to meet current and projected primary care needs. Without radical changes to the delivery and design of primary care, we will remain on an unsustainable trajectory. The entire system must be transformed.
Aim 1: Provide leadership as a trusted resource and partner in primary care transformation
The vision, mission, and specific aims of CIPCI require a commitment to engage, collaborate, and partner with a diverse range of stakeholders. Building trust, credibility, and transparency is vital to our execution and sustainability.
Key strategies for addressing Aim 1:
- Develop strategic partnerships with organizations with similar and complementary objectives.
- Serve as a convener and catalyst for critical discussions about primary care transformation.
- Initiate, evaluate, and communicate about innovations in primary care delivery and practice redesign.
Aim 2: Help practicing primary care providers keep pace with change
Effective and efficient primary care requires a strong foundation in quality improvement techniques, care design, optimal use of Health IT, patient engagement, and leadership to promote collaboration. The average practice lacks the knowledge, attitude, and skill-set to build this foundation – they are not sure where or how to start. CIPCI will serve as a trusted partner to guide and transform.
Key strategies for addressing Aim 2:
- Keep providers informed about the changing environment by using effective and efficient communication modes.
- Engage practicing providers to continually uncover opportunities for improvement and/or innovation.
- Partner with key stakeholders across the state to establish resources to support small practice redesign.
Aim 3: Improve training for primary care providers across disciplines
There is increasing recognition that current educational models are not adequately preparing primary care providers for the future. Barriers include inertia, regulations, traditional views toward curricular content, exponential growth in medical knowledge, the disjointed nature of primary care education, and inadequate attention to clinical leadership and management skills required for effective healthcare delivery. Some of the key aspects missing from curricula: inter-professional training, quality and safety, medical informatics, leadership development, implementation science, and learning environments conducive to education for future practice. These elements cannot simply be appended to what currently exists. We need new models to train primary care providers.
Key strategies for addressing Aim 3:
- Facilitate involvement of community-based primary care physicians in the design and implementation of medical student and resident training, and develop strategies to ensure mutual benefit.
- Facilitate development, testing, and evaluation of effective models for inter-professional team training.
- Provide innovative opportunities for practice and learning including simulation, advance technology, group improvement projects, and mentored self-directed learning.
- Engage and empower primary care trainees, patients, and practice teams as partners in care transformation.
- Provide classroom and practice-based education on proper application and effective use health information technology.
Aim 4: Increase the recruitment and retention of primary care providers
A recruitment and retention study published in the American Journal of Public Health examined factors influencing primary care physician practice decisions and found the following motivators:
|Personal Motivators||Career Motivators||Clinical Support Environment|
|Opportunities for personal growth||High career satisfaction – greater continuity of care, patient care, enriching experiences, and emotional satisfaction||Positive work environment – working with others who were part of a team who valued high-quality work|
|Extended job responsibilities||Low career satisfaction – boredom, burnout and lack of stability work hours, loan repayment, length of commute, salary and benefits, and retirement funds||Working with a provider team – including specialists, mental health providers, social service providers, and ancillary staff|
|Development of new skills||Work hours, length of commute, salary and benefits, and retirement funds||Reimbursement – financial remuneration and payment streams linked time spent in administrative tasks and electronic charting, laboratory orders, and results|
|Ways to augment one’s career||Loan repayment|
Key strategies for addressing Aim 4:
- Showcase high-performing primary care practices and engage their clinicians to share experiences and serve as mentors.
- Engage in local and national dialogues about addressing operational and financial barriers to entering and remaining in primary care practice.
- Support institutions in efforts to retrain clinicians for primary care practice.