The Future Of Family


Published on

Published in: Health & Medicine
  • Be the first to comment

  • Be the first to like this

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide

The Future Of Family

  1. 1. The Future of Family Medicine Project Paul Dassow, MD, MSPH CAM Retreat April 24, 2004
  2. 2. Objectives <ul><li>Give an overview of the Future of Family Medicine Project </li></ul><ul><li>Discuss aspects of the Recommendations that bear on Complementary and Alternative Medicine </li></ul>
  3. 3. The Background <ul><li>Keystone III – 2001 </li></ul><ul><li>Declining student interest in Family Medicine </li></ul><ul><li>Flat salaries for FP’s </li></ul><ul><li>New interest in FM “specialties” </li></ul><ul><li>30 years of FM evolution </li></ul>
  4. 4. Questions: <ul><li>Where is Family Medicine going? </li></ul><ul><li>What should the specialty look like in 10 years? </li></ul><ul><li>What do our customers/patients desire from us? </li></ul><ul><li>How can we continue to attract quality medical students? </li></ul>
  5. 5. “Crossing the Quality Chasm” <ul><li>“The system is so flawed, an overhaul is required to fix it” </li></ul><ul><li>21 st Century healthcare should be: </li></ul><ul><ul><li>Safe </li></ul></ul><ul><ul><li>Effective </li></ul></ul><ul><ul><li>Patient-Centered </li></ul></ul><ul><ul><li>Timely </li></ul></ul><ul><ul><li>Efficient </li></ul></ul><ul><ul><li>Equitable </li></ul></ul>
  6. 6. The Future of Family Medicine Project <ul><li>7 organizations came together to explore our future </li></ul><ul><li>Extensive research by 2 firms </li></ul><ul><ul><li>Medical students, residents, active FP’s </li></ul></ul><ul><ul><li>Other physicians </li></ul></ul><ul><ul><li>The general public </li></ul></ul><ul><li>Creation of 5 task forces </li></ul>
  7. 7. The Research <ul><li>Family physicians are not well recognized for who they are and what they do. </li></ul><ul><li>Patients want their PCP to : </li></ul><ul><ul><li>Take their insurance </li></ul></ul><ul><ul><li>Be conveniently located </li></ul></ul><ul><ul><li>See them in a reasonable period of time </li></ul></ul><ul><ul><li>Have good communications skills </li></ul></ul><ul><ul><li>Have a reasonable amount of experience </li></ul></ul>
  8. 8. The Research <ul><li>General skepticism that a generalist can stay current on a broad range of health care problems </li></ul><ul><li>Rated “Excellent” for communication and relationship skills </li></ul><ul><li>Do not associate FP’s with science and technology </li></ul>
  9. 9. Recommendations <ul><li>A new Identity Statement: </li></ul><ul><ul><li>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 </li></ul></ul>
  10. 10. Recommendations <ul><li>Change needed in three broad areas: </li></ul><ul><ul><li>Clinical Practice </li></ul></ul><ul><ul><li>Medical Education </li></ul></ul><ul><ul><li>The US Medical System </li></ul></ul>
  11. 11. Clinical Practice <ul><li>Introduction to the New Model of Care: </li></ul><ul><ul><li>Personal Medical Home </li></ul></ul><ul><ul><li>Patient-Centered Care </li></ul></ul><ul><ul><li>Team Approach </li></ul></ul><ul><ul><li>Elimination of barriers to access </li></ul></ul><ul><ul><li>Advanced information systems </li></ul></ul><ul><ul><li>Redesigned Offices </li></ul></ul>
  12. 12. Clinical Practice <ul><li>Introduction of the New Model of Care: </li></ul><ul><ul><li>Whole-person orientation </li></ul></ul><ul><ul><li>Care provided within a community context </li></ul></ul><ul><ul><li>Emphasis on quality and safety </li></ul></ul><ul><ul><li>Enhanced practice finance </li></ul></ul><ul><ul><li>Commitment to provide family medicine’s basket of services </li></ul></ul>
  13. 13. Medical Education <ul><li>Must be grounded in evidence-based medicine that is relevant to the care of the whole person in a relationship and community context </li></ul><ul><li>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 </li></ul>
  14. 14. Medical Education <ul><li>A 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. </li></ul>
  15. 15. Suggested Program Guidelines <ul><li>Flexibility/responsiveness </li></ul><ul><li>… </li></ul><ul><li>Supportive of critical thinking </li></ul><ul><li>… </li></ul><ul><li>Integration of evidence-based and patient centered knowledge </li></ul><ul><li>… </li></ul><ul><li>Collaborative and interdisciplinary approaches to all learning </li></ul>
  16. 16. Comprehensive Lifelong learning <ul><li>Continued development of: </li></ul><ul><ul><li>The physician as a person </li></ul></ul><ul><ul><li>The physician as a practicing professional </li></ul></ul><ul><ul><li>The patient care environment </li></ul></ul>
  17. 17. The US Medical System <ul><li>Ensure a medical home for all </li></ul><ul><li>Universal coverage </li></ul><ul><li>Promoting quality measures </li></ul><ul><li>Research supporting integrated care </li></ul><ul><li>Develop reimbursement to support PC </li></ul><ul><li>Asserting Family Medicine’s Leadership </li></ul>
  18. 18. CAM and the FOFM <ul><li>Clinical Practice </li></ul><ul><ul><li>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. </li></ul></ul><ul><ul><li>Patient-centered care also respects belief systems, which may prefer non-traditional therapies </li></ul></ul>
  19. 19. CAM and the FOFM <ul><li>Clinical Practice </li></ul><ul><ul><li>Whole-person orientation defined as “a commitment to integrated care through alliances with services that extend beyond the practice setting.” </li></ul></ul><ul><ul><li>The practice can help guide the patient through the system by integrating care, not simply coordinating it. </li></ul></ul>
  20. 20. CAM and the FOFM <ul><li>Clinical Practice </li></ul><ul><ul><li>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. </li></ul></ul>
  21. 21. CAM and the FOFM <ul><li>Education </li></ul><ul><ul><li>An emphasis on “scientific, evidence-based care”, and “critical thinking” means CAM must conform to accepted methods of analysis. </li></ul></ul><ul><ul><li>Biopsychosocial integration – A recommitment to the holistic model of health. Supports education of the mind-body interaction as well as the person/society interaction </li></ul></ul>
  22. 22. CAM and the FOFM <ul><li>Education </li></ul><ul><ul><li>“Collaborative and interdisciplinary approaches to all learning.” Encourages the team approach. Acknowledges the potential contribution of non-physician educators. </li></ul></ul><ul><ul><li>Development of physician as person: An opportunity for reflection and a broader understanding of personal wellness and development </li></ul></ul>
  23. 23. CAM and the FOFM <ul><li>The US Health System </li></ul><ul><ul><li>“Advancing research supporting the Integrated care of the whole person” </li></ul></ul><ul><ul><ul><li>A call to study real people in real situations under real conditions of stress </li></ul></ul></ul><ul><ul><ul><li>Research addressing illness rather than disease </li></ul></ul></ul><ul><ul><ul><li>An open door for multi-modality care </li></ul></ul></ul>
  24. 24. Summary <ul><li>A New Vision </li></ul><ul><ul><li>A new identity </li></ul></ul><ul><ul><li>The New Model </li></ul></ul><ul><ul><li>New educational guidelines </li></ul></ul><ul><ul><li>A new System </li></ul></ul><ul><li>Opportunities </li></ul><ul><ul><li>Implementation </li></ul></ul><ul><ul><li>Research </li></ul></ul><ul><ul><li>True Integrated Care </li></ul></ul>