Report from CEO Terry McGeeney

Leadership and the Corner Drug Store

As I was driving recently, I noticed a large sign hanging on a pharmacy retail clinic advertising school and camp physicals. There are rumors that the retail clinics want to provide occupational medicine services and employment physicals will soon follow, certainly opening the potential to all physicals and who knows what else.

The advance of retail clinics into the space between patients and their primary care physicians is not the fault of the retail clinics. It is a response to patient needs and capitalism at work. The fault lies in the failure of primary care to lead and communicate.

The recently completed TransforMED National Demonstration Project shows quite clearly that the two greatest vulnerabilities for practices seeking to become Patient-Centered Medical Homes are lack of leadership and lack of communication. These weaknesses relate directly to primary practices not providing what their patients need when they need it and are why retail clinics continue to expand in their number and scope of services.

Communication fails at multiple levels. Providers do not often effectively communicate with each other, they do not communicate with their staff and they certainly do not effectively communicate with their patients. All three levels of communication are critical success factors for PCMH implementation. All three are critical success factors for patients seeking care in their medical home and not in the corner drug store.

Providers need to clearly define the mission and goals of the practice. In order to do that they need to communicate with each other and then communicate with staff. If staff understands and buys into the mission and goals, they will be more likely to make the effort to implement the changes necessary to provide patients the care they need when they need it. Finally, providers need to communicate with their patients to find out what they expect from their medical homes.

Effective communication is a tool that is dependent on leadership. Primary Care is at a unique place in time – that may not come again – to redefine its role in the US healthcare system. The challenge is this: due to the lack of communication and the lack of leadership, there are several entities developing that will continue to fragment care and prevent coordination and collaboration. Primary Care physicians must communicate and lead and say this is not acceptable.

Primary Care physicians must lead at the national, state and local levels to promote the value of primary care and patient centered medical homes. There must not only be the leadership to promote, but to deliver.

Primary Care physicians must communicate and lead to provide the care patients need in a medical home so there is no reason for patients to seek care at the corner drug store. Primary care practices must transform themselves to Patient-Centered Medical Homes. These medical homes must provide the care patients need when they need it. These medical homes must also coordinate all of the care of the patients that claim this practice as their "home".

The Future of Family Medicine report clearly stated that time is short, and many of us believe it is getting shorter. Primary Care is at a unique crossroads in history. We can either communicate and lead or fall by the wayside as patients vote with their feet and capitalism rules.