the future of family
DESCRIPTION
TRANSCRIPT
The Future of Family Medicine Project
Paul Dassow, MD, MSPH
CAM Retreat
April 24, 2004
Objectives
Give an overview of the Future of Family Medicine Project
Discuss aspects of the Recommendations that bear on Complementary and Alternative Medicine
The BackgroundKeystone III – 2001Declining student interest in Family
MedicineFlat salaries for FP’sNew interest in FM “specialties”30 years of FM evolution
Questions:Where is Family Medicine going?What should the specialty look like in 10
years?What do our customers/patients desire
from us?How can we continue to attract quality
medical students?
“Crossing the Quality Chasm” “The system is so flawed, an overhaul is
required to fix it”21st Century healthcare should be:
Safe Effective Patient-Centered Timely Efficient Equitable
The Future of Family Medicine Project
7 organizations came together to explore our future
Extensive research by 2 firms Medical students, residents, active FP’s Other physicians The general public
Creation of 5 task forces
The ResearchFamily physicians are not well
recognized for who they are and what they do.
Patients want their PCP to : Take their insurance Be conveniently located See them in a reasonable period of time Have good communications skills Have a reasonable amount of experience
The ResearchGeneral skepticism that a generalist can
stay current on a broad range of health care problems
Rated “Excellent” for communication and relationship skills
Do not associate FP’s with science and technology
RecommendationsA new Identity Statement:
Family Physicians are committed to fostering health and integrating health care for the whole person by humanizing medicine and providing science-based high-quality care
RecommendationsChange needed in three broad areas:
Clinical Practice
Medical Education
The US Medical System
Clinical Practice Introduction to the New Model of Care:
Personal Medical Home Patient-Centered Care Team Approach Elimination of barriers to access Advanced information systems Redesigned Offices
Clinical Practice Introduction of the New Model of Care:
Whole-person orientation Care provided within a community context Emphasis on quality and safety Enhanced practice finance Commitment to provide family medicine’s
basket of services
Medical EducationMust be grounded in evidence-based
medicine that is relevant to the care of the whole person in a relationship and community context
Must be technologically up-to-date, built on a foundation of clinical science, and strong in the components of interpersonal and behavioral skills including cultural competence
Medical EducationA Family Medicine Residency must train
physicians to deliver patient-centered care consistently and lead an interdisciplinary team, emphasizing the biopsychosocial model, cultural proficiency, evidence-based practice, quality improvement, informatics and practice-based research.
Suggested Program GuidelinesFlexibility/responsiveness…Supportive of critical thinking… Integration of evidence-based and
patient centered knowledge…Collaborative and interdisciplinary
approaches to all learning
Comprehensive Lifelong learning
Continued development of:
The physician as a person
The physician as a practicing professional
The patient care environment
The US Medical System
Ensure a medical home for allUniversal coveragePromoting quality measuresResearch supporting integrated careDevelop reimbursement to support PCAsserting Family Medicine’s Leadership
CAM and the FOFMClinical Practice
Patient-centered care dictates a strong relationship which treats illness, not just disease. As such, many traditional methods of treatment may fall short of what can be achieved.
Patient-centered care also respects belief systems, which may prefer non-traditional therapies
CAM and the FOFMClinical Practice
Whole-person orientation defined as “a commitment to integrated care through alliances with services that extend beyond the practice setting.”
The practice can help guide the patient through the system by integrating care, not simply coordinating it.
CAM and the FOFMClinical Practice
The Basket of Services includes integration of personal health care as well as activities related to disease prevention and health promotion. Many CAM practices not only have therapeutic benefits, but also fall in these latter two categories. An area of needed research.
CAM and the FOFMEducation
An emphasis on “scientific, evidence-based care”, and “critical thinking” means CAM must conform to accepted methods of analysis.
Biopsychosocial integration – A recommitment to the holistic model of health. Supports education of the mind-body interaction as well as the person/society interaction
CAM and the FOFMEducation
“Collaborative and interdisciplinary approaches to all learning.” Encourages the team approach. Acknowledges the potential contribution of non-physician educators.
Development of physician as person: An opportunity for reflection and a broader understanding of personal wellness and development
CAM and the FOFMThe US Health System
“Advancing research supporting the Integrated care of the whole person”
A call to study real people in real situations under real conditions of stress
Research addressing illness rather than disease
An open door for multi-modality care
Summary A New Vision
A new identity The New Model New educational
guidelines A new System
Opportunities Implementation Research True Integrated Care
