Academic Medicine: A Key Partner in Strengthening the Primary Care Infrastructure Via Teaching Health Centers
Dr. Rieselbach is professor emeritus of medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. Dr. Crouse is professor of family medicine, associate dean, Rural and Community Health, and director, Wisconsin Academy of Rural Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. Dr. Neuhausen is director, Delivery System Reform, Office of Health Innovation, and clinical assistant professor, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia. Dr. Nasca is chief executive officer, Accreditation Council for Graduate Medical Education, Chicago, Illinois, and professor of medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania. Dr. Frohna is professor of pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, and program director, American Family Children's Hospital Pediatric Residency, Madison, Wisconsin.Academic medicine: journal of the Association of American Medical Colleges (Impact Factor: 2.93). 10/2013; 88(12). DOI: 10.1097/ACM.0000000000000035
In the United States, a worsening shortage of primary care physicians, along with structural deficiencies in their training, threaten the primary care system that is essential to ensuring access to high-quality, cost-effective health care. Community health centers (CHCs) are an underused resource that could facilitate rapid expansion of the primary care workforce and simultaneously prepare trainees for 21st-century practice. The Teaching Health Center Graduate Medical Education (THCGME) program, currently funded by the Affordable Care Act, uses CHCs as training sites for primary-care-focused graduate medical education (GME).The authors propose that the goals of the THCGME program could be amplified by fostering partnerships between CHCs and teaching hospitals (academic medical centers [AMCs]). AMCs would encourage their primary care residency programs to expand by establishing teaching health center (THC) tracks. Modifications to the current THCGME model, facilitated by formal CHC and academic medicine partnerships (CHAMPs), would address the primary care physician shortage, produce physicians prepared for 21st-century practice, expose trainees to interprofessional education in a multidisciplinary environment, and facilitate the rapid expansion of CHC capacity.To succeed, CHAMP THCs require a comprehensive consortium agreement designed to ensure equity between the community and academic partners; conforming with this agreement will provide the high-quality GME necessary to ensure residency accreditation. CHAMP THCs also require a federal mechanism to ensure stable, long-term funding. CHAMP THCs would develop in select CHCs that desire a partnership with AMCs and have capacity for providing a community-based setting for both GME and health services research.
- Academic medicine: journal of the Association of American Medical Colleges 10/2013; 88(12). DOI:10.1097/ACM.0000000000000030 · 2.93 Impact Factor
- 12/2013; 5(4):556-9. DOI:10.4300/JGME-05-04-39
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ABSTRACT: Background: Although primary care general internists (PCGIs) are essential to the physician workforce and the success of the Affordable Care Act, they are becoming an endangered species. Objective: We describe an expanded program to educate PCGIs to meet the needs of a reformed health care system and detail the competencies PCGIs will need for their roles in team-based care. Intervention: We recommended 5 initiatives to stabilize and expand the PCGI workforce: (1) caring for a defined patient population, (2) leading and serving as members of multidisciplinary health care teams, (3) participating in a medical neighborhood, (4) improving capacity for serving complex patients in group practices and accountable care organizations, and (5) finding an academic role for PCGIs, including clinical, population health, and health services research. A revamped approach to PCGI education based in teaching health centers formed by community health center and academic medical center partnerships would facilitate these curricular innovations. Anticipated outcomes: New approaches to primary care education would include multispecialty group practices facilitated by electronic consultation and clinical decision-support systems provided by the academic medical center partner. Multiprofessional and multidisciplinary education would prepare PCGI trainees with relevant skills for 21st century practice. The centers would also serve as sites for state and federal Medicaid graduate medical education (GME) expansion funding, making this funding more accountable to national health workforce priorities. Conclusions: The proposed innovative approach to PCGI training would provide an innovative educational environment, enhance general internist recruitment, provide team-based care for underserved patients, and ensure accountability of GME funds.06/2014; 6(2):395-8. DOI:10.4300/JGME-D-14-00119.1
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