To ensure an uninterrupted primary care continuum, health care organizations should create a position for a chief primary care medical officer (CPCMO), Noemi Doohan, a physician at the University of California, Davis, and Jennifer DeVoe, a physician at Oregon Health & Science University, argue in the Annals of Family Medicine.
The problem: A disruption in primary care
According to the authors, "Despite many current payment and delivery systems rewarding [care] discontinuity and severing long-term relationships between patient and primary care teams at the hospital door, primary care does not stop being important when a person is admitted to the hospital." And disrupting primary care "causes real harm to patients," Doohan and DeVoe write.
Hospitals can address that discontinuity by instituting the role of CPCMO, the authors write. Doohan and DeVoe explain, "The CPCMO can lead hospital efforts to create systems that ensure primary care's continuum is complete, while strengthening physician collaboration across specialties, and moving toward achieving the Quadruple Aim of enhancing patient experience, improving population health, reducing costs and improving the work life of healthcare providers."
The position is also an "essential role" in the overall industry shift toward value-based care, Doohan and DeVoe write, as the CPCMO would help lead efforts to curb readmission rates and lengths of stay while improving patient satisfaction.
The CPCMO's job description
According to Doohan and DeVoe, the CPCMO would helm a hospital's efforts to coordinate care between a patient's primary care provider and hospitalists.
Ideally, they write, the CPCMO would be a primary care physician who would allocate a quarter of his or her time to continuity clinic work; a quarter to hospital-based clinic work, including daily hospital case management; and half to administrative work as a hospital leader.
Further, the CPCMO should have membership and voting privileges on key hospital committees, including the Medical Executive Committee and other leadership committees, Doohan and DeVoe write.
"This is a call for family medicine as a discipline to re-evaluate our purpose, and re-embrace our mission by championing innovations such as the CPCMO which are inspired by the traditional primary care values of personal doctoring," Doohan and DeVoe conclude. "As family physicians, we can (and must) reclaim our personal physician role in our patients' lives and communities and advocate for system changes that support better health" (Vartorella, Becker's Hospital Review, 8/9; MacDonald, Fierce Healthcare, 8/9; Doohan/DeVoe, The Annals of Family Medicine, July/August 2017).
New: Review the 4 primary care models for geriatric patients
As the geriatric population expands, health systems must adapt to manage the needs of this patient population. These patients are not simply older adults. They require specialized clinical care due to their unique health status and vulnerability.
This market scan reviews four models for fixed or mobile primary care, including geriatrics clinics, providing primary care in assisted living facilities, forming house call programs, and an overview of strategies to geriatricize existing primary care practices.