Let the renaissance of primary care begin

I'm hoping I'll be able to fall asleep tonight.  I just came from a meeting with colleagues in NYC.  I met with Moitri, Soma, Sofia, Bruce, Matt, Sean, Michele, Carrie.

These independent primary care practices want to come together to delivery and demonstrate exemplary primary care.  We know we can do it.  We talked about how we can use a common data platform to measure the quality of care we deliver based not on the "chase a thousand points of detail" but rather on key indicators of how our practices perform as systems of care for our patients.

We have confidence (based on previously published data as well as personal experience doing this work) that we will be able to demonstrate care delivery that anticipates vastly superior outcomes (avoiding unnecessary hospital admission or emergency room use, helping people improve their lifestyle, work on wellness as well as chronic disease management).

We know that there are self funded employers desperate to offer a better health care experience to their employees and yearning for better outcomes that reduce their costs, and we know how to talk with them.

I'm done playing mother-may-I medicine. 
I'm done begging clerks to approve needed treatments for patients.

I'm done playing quality Twister trying to prove my worth against a silly quality paradigm that is so blatantly biased to reward big institutional practices and punish small ones.
I'm done begging for pennies on the dollars I need to fund the full scope of my work.

I'm totally jazzed that this group of solo and small practices is willing to come together around doing the right thing for their patients, willing to hold themselves to the highest standards of care, to measure and report and if need be to work hard to improve.

I'll blog more as we get this thing going.

Comments

[L Gordon Moore]

The drag for those coming out of residency is that few have had the opportunity to see high functioning primary care in action. Most come out with strong ideas of what they would like to avoid (bearing witness to the systemic dysfunction). Many believe that they can come into an existing practice and change the culture.
Three to five years into their new careers, most will find themselves on the hamster wheel, trying to balance do the right thing for my patients with do what Im asked to do by practice/corporate/health system policy. Too many will start down the road to burnout trying to shore up the dysfunction through sheer effort.
As more find high functioning primary care options we hope that the trend in practice will shift more and more to rewarding careers in primary care - clinicians who feel that they are supported in delivering the best of what they have to offer to their patients.

[W. Ryan Neuhofel]

Gordon,
You are head of the IMP project, correct? I have spoke to many docs who have implemented your 'style' of care who've had great results. I hope my generation of physicians continues to challenge the status quo. Unfortunately, too many of my residency colleagues are complacent with their potential careers.

[L Gordon Moore]

Way to go Ryan!
Ping me when youre ready.
Gordon

[W. Ryan Neuhofel]

amen! I will be right there with you after graduating residency next year. I am not waiting around for some bureaucrat or corporate big-wig to help me provide better, cheaper care to my patients.

[dave gordon]

sometimes the attempt to prove our worth to the mainstream and politcal realm seems hopefully but knowledege that I have provided excellent care to my small family of patients seems to be enough - hopefully in concert amongst us all we can generate the data that proves our model to the decision makers so in time everyone can benefit from what imps do