This document defines primary care and discusses opportunities in the field. It summarizes that primary care aims to provide accessible, integrated healthcare through partnerships with patients. It then discusses how primary care is being transformed through new models like the patient-centered medical home. The document introduces innovators reinventing primary care and encourages the reader to envision a role in this changing field, which faces challenges but opportunities to improve quality and lower costs.

1. Primary Care: The Opportunities& You Primary Care Progress

2. Agenda Define primary healthcare and identify the value it creates Explore how primary care is being transformed Introduce you to innovators who are reinventing the field Help you envision a role for yourself in this field

4. developing a substantial partnership with patients

5. practicing in the context of family and community” - The Institute of Medicine, 1996

6. Primary Care Re-imagined

7. Meet MJ

8. Meet MJ

9. MJ Today

10. Ideal Acute Care Access Care based in longitudinal relationships Appropriate treatment Use of IT & EBM Care coordination

11. Ideal Chronic Care .

12. Ideal Chronic Care Enhanced access Evidence based treatment Education and empowerment Team-based cared Care coordination

13. Ideal vs Reality Patient centered Team based Coordinated Proactive Doctor centered Siloed Fragmented Reactive POOR ORGANIZATION

14. The Patient-Centered Medical Home New models of care focusing on: Patient-centeredness Collaboration Comprehensive care Accessibility Coordination Extensive use of IT & EMR Accountability

15. The Patient’s Experience Video follows…

16. The Health Professional’s Experience Video follows…

17. Far From Perfect Patients receiving only 55% of recommended care Rates of proving clinical preventive services are low 55% of routine screening tests 24% immunizations 9% of health-habit counseling services McGlynn EQ et al. NEJM 2003;348:2635-2645 Stange KC et al. Prev Med. 2000;31:167-176

18. Far From Perfect “Every system is perfectly designed to produce the results it gets.” - Donald Berwick

19. Change is Afoot Supportive multi-stakeholder coalition New health law Increased payment to primary care providers Innovation grants Expanded training programs

20. Why the change in support? Current system is bankrupting us Despite high spending, we receive poor value We need a robust primary care foundation!

21. Value added by Primary Care Increased quality & decreased overall spending Improved patient satisfaction Increased provision of appropriate preventive services Decreased use of Emergency Department resources Fewer hospital admissions O’Malley AS, et al. Arch Intern Med 1997;157(13) Saultz JW, et al. Ann Fam Med 2004;2(5): 445-51 Petersen LA, et al. Med Care 1998;36(8): 1249-55 Medicare claims data; and Area Resource File, 2003

22. We all have our own stories

23. The Field is Reinventing Itself… This is a work in progress We’re incorporating ideas from outside of medicine We’re harnessing the true potential of the workforce

24. Clinical Innovation Video follows…

25. Wonderful Opportunity for Trainees To bring trainees’ fresh perspectives and unique skills to bear To add tremendous value To craft a fulfilling career

28. Challenges We Face An increasing demand for primary care services while our supply of providers is shrinking. Questionable quality of services rendered Dysfunctional reimbursement system New health law adds millions of new patients who need primary care

29. Where Primary Care Is Robust, Quality Is Higher

30. Where Primary Care Is Robust, Spending Is Lower