Be the Change You Want to See

The national climate can feel a little gloomy right now with foreclosures at an all-time high, unemployment on the rise, and now a possible pandemic on the horizon. The news in the healthcare arena doesn't feel much better – the latest Match results show primary care specialties are slipping again in the eyes of US medical students.

So why am I so hopeful? Maybe it's a case of things getting darker before the dawn. Maybe the US healthcare system had to hit crisis mode before we could make the necessary sweeping changes that seem to be on the cusp of becoming reality. Here are the things that make me hopeful for a better tomorrow for primary care practices:

• Stimulus funds are being set aside to address technology in medical practices. Of course, there are always concerns about how funds such as these will be distributed, but there are some great minds at work on this problem. I think there's hope that between the stimulus money and the latest technology updates, practices will have access to real, interoperable and affordable options to electronic records and disease registries.


• Nationwide interest in primary care is at an all-time high. President Obama is quoted as saying, "We're not producing enough primary care physicians." Senator Max Baucus added that, "Primary care physicians are grossly underpaid compared with many specialists." According to this week's New York Times, Mr. Baucus also vowed to increase money paid to primary care as a means to overhaul the health care system.


• Primary care has some powerful friends in influential places. The Patient-Centered Primary Care Collaborative (www.PCPCC.net) has been successful in drawing in representatives from major primary care organizations, large employers (IBM, Johnson & Johnson, Microsoft, just to name a few), and other major players in the US Healthcare system. Other organizations such as the Medicare Payment Advisory Committee (Medpac) are making a difference as well.


• Demonstration and Pilot Projects are taking place all over the country to produce evidence demonstrating the value of integrated, continuity of care, now being referred to as Patient-Centered Medical Home. What's important is to ensure that these pilots don't study only chronic diseases, which are an important piece of primary care, but only one part of a full, comprehensive type of care.


• TransforMED is engaged with many medical practices from around the country that are committed to the process of becoming PCMH practices. Some of these practices include the 32 medical practices that took part in the National Demonstration Project practices. They met recently for an exciting reunion meeting here in Kansas City. You can learn more about this meeting by reading this article and we even have video interviews with some of the practices you can view.

I know there are those around the country that are starting to say that the PCMH train may be coming off the tracks.  That it may just be "managed care" with a new name.  While most of us believe that those statements are not accurate, they are being said and published.  The reality, however, is that the momentum for PCMH continues to expand and grow. 

The Patient-Centered Medical Home concept does three important things for our healthcare community now:

1.   PCMH creates a framework for change

2.   PCMH creates a common language for change

3.   PCMH creates the opportunity for change.

Patient-Centered Medical Home is first and foremost about the relationship between everyone in the practice – physicians, clinical staff, and office staff – and the patient.

PCMH also embraces leveraging technology in a meaningful way, learning to provide care as a team, providing comprehensive care for the whole person, managing chronic disease as well as providing prevention, coordinating care, and ensuring easy access to care and information. Of course, all of this must be done with a keen eye on practice management to provide financial stability and ease of operations.

Patient-Centered Medical Home. If the name bothers you, don't let it. It may not pass the test of time, but the concepts behind it certainly will. How can you get on board? There is no one path, but rather, many paths to a single goal. You can create your own path or hitch to another car, or you can join the practices working with TransforMED. You can do that for free by using our MHIQ to learn about the medical home components, to self-assess how your practice is doing, and improve your practice with the many online resources. Or you can join our Delta-Exchange collaborative network, which provides a low-cost option for an exciting online practice change community, including information from our Practice Facilitators.

The change needed in this country must be broad-reaching and systemic.  It is about redesigning how healthcare is delivered in this country and not just picking at the edges of a broken system.  We need to focus on the all-important concepts and the value that PCMH offers our healthcare system at this pivotal time in our history. There may never be a moment like this in our country again. I urge you all not to sit on the sidelines and watch this train go by. This is your call to action, your chance to be the change you want to see.