Hospitals in pursuit of excellence

Designing A 21st Century Approach to Primary Care

Although primary care is expected to be  safe, effective, patient-centered, timely, efficient, and equitable, it often is not.  Research indicates that patients' overall satisfaction with primary care is limited and that substantial numbers of primary care practitioners report dissatisfaction with their field and concerns about its future. Today's primary care system is also troubled financially.

A paper by John Griffith, Kyle Grazier, and Scott Ransom proposes to remedy these problems with a new vision of primary care. They reference successful business models as a way to revolutionize primary care via improvements in marketing (both to patients and caregivers), logistic support functions, clinical practice functions, and financial management. The authors believe that, to achieve success, the new primary care system must:

• be responsive to patient needs so that patient-customers return when appropriate and recommend the provider to others;
• create a desirable "product" by providing benchmark level care against IOM goals and seeking continuous improvement in treatment quality and effectiveness;
• retain and attract caregivers by "delighting" practitioners in the areas of personal and professional satisfaction with their careers;
• provide care that maximizes value and effectively manages referrals for patients who need specialty care;
• use financial incentives to reward providers and patients for constructive behavior.
• be implemented without substantially disrupting current patient care or a physician's practice.