Russell S Phillips

Russell S Phillips
Harvard Medical School | HMS · Center for Primary Care

MD

About

376
Publications
62,421
Reads
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36,331
Citations
Citations since 2016
42 Research Items
10082 Citations
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Introduction
Skills and Expertise
Additional affiliations
July 2002 - June 2012
Beth Israel Deaconess Medical Center
Position
  • Division Chief, General Medicine and Primary Care
July 2002 - June 2012
Harvard Medical School
Position
  • Division Chief, General Medicine and Primary Care, Beth Israel Deaconess Medical Center
January 2002 - December 2011
Education
September 1975 - June 1979
Stanford Medicine
Field of study
  • Medicine
September 1971 - June 1975
Massachusetts Institute of Technology
Field of study
  • Life Sciences

Publications

Publications (376)
Article
Reliable systems that track the continuation, progression, or resolution of a patient’s symptoms over time are essential for reliable diagnosis and ensuring that patients harboring more worrisome diagnoses are safely followed up. Given their first-contact role and increasing stresses on busy primary care clinicians and practices, new processes that...
Article
Importance: Following up on recommendations from radiologic findings is important for patient care, but frequently there are failures to carry out these recommendations. The lack of reliable systems to characterize and track completion of actionable radiology report recommendations poses an important patient safety challenge. Objectives: To char...
Article
Rates of burnout among clinicians have been exacerbated by the COVID-19 (COVID)pandemic. A survey of Missouri primary care professionals at federally qualified health centers was conducted during a COVID surge in August 2021 to assess burnout, stress, and job satisfaction as well as if respondents had sought assistance for burnout or attended resil...
Article
Background: COVID-19 impacted primary care delivery, as clinicians and practices implemented changes to respond to the pandemic while safely caring for patients. This study aimed to understand clinicians' perceptions of the positive and negative impacts of COVID-19 on primary care in New England. Methods: This qualitative interview study was con...
Article
Background: In response to the complexity, challenges, and slow pace of innovation, health care organizations are adopting interdisciplinary team approaches. Systems engineering, which is oriented to creating new, scalable processes that perform with higher reliability and lower costs, holds promise for driving innovation in the face of challenges...
Article
Full-text available
Background Closing loops to complete diagnostic referrals remains a significant patient safety problem in most health systems, with 65%–73% failure rates and significant delays common despite years of improvement efforts, suggesting new approaches may be useful. Systems engineering (SE) methods increasingly are advocated in healthcare for their val...
Article
Purpose: Studies demonstrate how patient roles in system redesign teams reflect a continuum of involvement and influence. This research shows the process by which patients move through this continuum and effectively engage within redesign projects. Design/methodology/approach: The authors studied members of redesign teams, consisting of 5-10 mem...
Preprint
Full-text available
Rapid, widespread COVID-19 vaccination is critical to pandemic mitigation and recovery. To help policymakers interested in further enhancing primary care delivery of COVID-19 vaccines, it is important to estimate the absolute number of vaccination opportunities, and identify how these opportunities may fall disproportionately among different commun...
Article
COVID-19 necessitated significant care redesign, including new ambulatory workflows to handle surge volumes, protect patients and staff, and ensure timely reliable care. Opportunities also exist to harvest lessons from workflow innovations to benefit routine care. We describe a dedicated COVID-19 ambulatory unit for closing testing and follow-up lo...
Article
Background: Prior studies have reported that greater numbers of primary care physicians (PCPs) per population are associated with reduced population mortality, but the effect of increasing PCP density in areas of low density is poorly understood. Objective: To estimate how alleviating PCP shortages might change life expectancy and mortality. De...
Article
Objective Examine care integration—efforts to unify disparate parts of health care organizations to generate synergy across activities occurring within and between them—to understand whether and at which organizational level health systems impact care quality and staff experience. Data Sources Surveys administered to one practice manager (56/59) a...
Article
Full-text available
The challenges wrought by the COVID-19 pandemic on health systems have tested primary care clinicians, who are on the front lines of care delivery. To ensure the longevity of the primary care workforce, strong interprofessional teams are one important solution to alleviating burnout and increasing clinician and patient satisfaction, but the pandemi...
Article
To transform primary care with the goal of achieving health equity, changes in the way the health care workforce is selected, trained, and ultimately delivers care should be expedited. Research has repeatedly shown the immense impact of the social determinants of health and the gaps related to health equity in the United States. Despite this knowle...
Article
Purpose: We sought to determine the financial impact to primary care practices of alternative strategies for offering buprenorphine-based treatment for opioid use disorder. Methods: We interviewed 20 practice managers and identified 4 approaches to delivering buprenorphine-based treatment via primary care practice that differed in physician and...
Article
Due to the novel coronavirus disease (COVID-19), virtually all in-person outpatient visits were cancelled in many parts of the country between February and May 2020. We sought to estimate the potential impact of COVID-19 on operating expenses and revenues of primary care practices.Using a microsimulation model incorporating national data on primary...
Article
Full-text available
Given the widespread lack of access to dental care for many vulnerable Americans, there is a growing realization that integrating dental and primary care may provide comprehensive care. We sought to model the financial impact of integrating dental care provision into a primary care practice. A microsimulation model was used to estimate changes in n...
Article
Oral disease is strongly affected by social determinants of health, policy, genetics, and other factors. Because of the multifaceted nature of oral health, many members of the health care team can participate in oral care services. Primary care providers (PCPs) are essential team members. Patients often visit PCPs while forgoing dental care. Primar...
Article
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Background/objective: High levels of chronic stress negatively impact the hippocampus and are associated with increased incidence of mild cognitive impairment (MCI) and Alzheimer's disease. While mindfulness meditation may mitigate the effects of chronic stress, it is uncertain if adults with MCI have the capacity to learn mindfulness meditation....
Article
Background and objectives: Despite recent improvements in access to health care, many Americans still lack access to dental care. There has been a national focus on interprofessional education and team-based care to work toward the integration of services including dental care into primary care. The purpose of this systematic review is to understa...
Article
Importance Recent US health care reforms incentivize improved population health outcomes and primary care functions. It remains unclear how much improving primary care physician supply can improve population health, independent of other health care and socioeconomic factors. Objectives To identify primary care physician supply changes across US co...
Article
States are introducing regulations to slow health care spending growth, but which of these successfully reduce spending growth remains unclear. We studied Rhode Island's 2010 affordability standards, which imposed price controls-particularly inflation caps and diagnosis-based payments-on contracts between commercial insurers and hospitals and clini...
Article
Purpose Health care systems increasingly demand health professionals who can lead interdisciplinary teams. While physicians recognize the importance of leadership skills, few receive formal instruction in this area. This paper aims to describe how the Student Leadership Committee (SLC) at the Harvard Medical School Center for Primary Care responde...
Article
Full-text available
Purpose: To estimate the conditions under which team documentation-having a staff member enter history, place orders, and guide patients-would be financially viable at primary care practices, accounting for implementation costs. Methods: We applied a validated microsimulation model of practice costs, revenues, and time use to data from 643 US pr...
Article
Efforts to transform health care delivery to improve care have increasingly focused on care integration. However, variation in how integration is defined has complicated efforts to design, synthesize, and compare studies of integration in health care. Evaluations of integration initiatives would be enhanced by describing them according to clear def...
Article
Background: New payments from Medicare encourage behavioral health services to be integrated into primary care practice activities. Objective: To evaluate the financial impact for primary care practices of integrating behavioral health services. Design: Microsimulation model. Participants: We simulated patients and providers at federally qua...
Article
Capitated payments in the form of fixed monthly payments to cover all of the costs associated with delivering primary care could encourage primary care practices to transform the way they deliver care. Using a microsimulation model incorporating data from 969 US practices, we sought to understand whether shifting to team- and non-visit-based care i...
Article
Background: Colorectal cancer (CRC) is a leading cause of cancer death, reducible by screening and early diagnosis, yet many patients fail to receive recommended screening. As part of an academic improvement collaborative, 25 primary care practices worked to improve CRC screening and diagnosis. Methods: The project featured triannual learning se...
Article
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The United States has the most expensive, technologically advanced, and sub-specialized healthcare system in the world, yet it has worse population health status than any other high-income country. Rising healthcare costs, high rates of waste, the continued trend towards chronic non-communicable disease, and the growth of new market entrants that c...
Article
Background As the US transitions to value-based healthcare, physicians and payers are incentivized to change healthcare delivery to improve quality of care while controlling costs. By assisting with the management of common chronic conditions, community health workers (CHWs) may improve healthcare quality, but physicians and payers who are making c...
Article
Innovations in payment are encouraging clinical-community partnerships that address health determinants. However, little is known about how healthcare systems transform and partner to improve population health. We synthesized views of population health experts from nine organizations and illustrated the resulting model using examples from four heal...
Article
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Sanjay Basu and Russell Phillips discuss the findings from Whittaker and colleagues on the link between extending primary care hours and emergency department utilization.
Article
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PURPOSE We assess the financial implications for primary care practices of participating in patient-centered medical home (PCMH) funding initiatives. METHODS We estimated practices’ changes in net revenue under 3 PCMH funding initiatives: increased fee-for-service (FFS) payments, traditional FFS with additional per-member-per-month (PMPM) payments...
Article
Background: Uncertainty about the financial costs and benefits of community health worker (CHW) programs remains a barrier to their adoption. Objectives: To determine how much CHWs would need to reduce emergency department (ED) visits and associated hospitalizations among their assigned patients to be cost-neutral from a payer's perspective. Re...
Article
Background: Physicians have traditionally been reimbursed for face-to-face visits. A new non-visit-based payment for chronic care management (CCM) of Medicare patients took effect in January 2015. Objective: To estimate financial implications of CCM payment for primary care practices. Design: Microsimulation model incorporating national data o...
Article
Adoption of new primary care models has been slow in academic teaching practices. We describe a common framework that academic learning collaboratives are using to transform primary care practice based on our analysis of 6 collaboratives nationally. We show that the work of the collaboratives could be divided into 3 phases and provide detail on the...
Article
Challenged by demands to reduce costs and improve service delivery, the U.S. health care system requires transformational change. Health systems innovation is defined broadly as novel ideas, products, services, and processes-including new ways to promote healthy behaviors and better integrate health services with public health and other social serv...
Article
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As American medicine continues to undergo significant transformation, the patient-centered medical home (PCMH) is emerging as an interprofessional primary care model designed to deliver the right care for patients, by the right professional, at the right time, in the right setting, for the right cost. A review of local, state, regional and national...
Article
Primary care practice transformations require tools for policymakers and practice managers to understand the financial implications of workforce and reimbursement changes. To create a simulation model to understand how practice utilization, revenues, and expenses may change in the context of workforce and financing changes. We created a simulation...
Article
Full-text available
To the Editor: I agree with Record's assertion, in her Perspective article in the April 24 issue,(1) that we need to strengthen the ability of our health system to care for patients with mental health disorders. However, she has unfairly targeted primary care physicians (PCPs) as the problem. In fact, much of our practice and training is focused on...
Article
Problem: Academic medical centers (AMCs) need new approaches to delivering higher-quality care at lower costs, and engaging trainees in the work of high-functioning primary care practices. Approach: In 2012, the Harvard Medical School Center for Primary Care, in partnership with with local AMCs, established an Academic Innovations Collaborative...
Article
Full-text available
Periodontitis is a common chronic inflammatory disease initiated by bacteria, resulting in bone resorption, tooth loss, and systemic inflammation. Long-chain omega-3 fatty acids such as docosahexaenoic acid (DHA) reduce periodontitis in animals. We aimed to determine whether DHA supplementation with low-dose aspirin would reduce periodontitis in hu...
Article
Those with high baseline stress levels are more likely to develop mild cognitive impairment (MCI) and Alzheimer's Disease (AD). While meditation may reduce stress and alter the hippocampus and default mode network (DMN), little is known about its impact in these populations. Our objective was to conduct a "proof of concept" trial to determine wheth...
Article
Adverse drug events (ADEs) are common in ambulatory care and may result from poor patient-physician communication about medication-related symptoms. A module was developed within an electronic patient portal that was designed to enhance communication about medication symptoms and, in turn, reduce ADEs and health-care utilization. The researchers co...
Article
In 2002 the American Medical Student Association (AMSA) created a fourth-year medical student elective known as the Humanistic Elective in alternative medicine, Activism, and Reflective Transformation (HEART) that provided the opportunity for students to explore humanism in medicine, self-care, complementary and alternative medicine modalities, com...
Article
Neuropsychiatric symptoms affect 37% of US adults and present in many important diagnoses including posttraumatic stress disorder, traumatic brain injury, and chronic pain. However, these symptoms are difficult to treat with standard treatments, and patients may seek alternative options. In this study, we examined the use of mind-body therapies by...
Article
Full-text available
Importance Patients undergoing hemodialysis have an annual mortality rate exceeding 20%, comparable to many types of cancer. Past research has shown that patients with cancer overestimate their likelihood of survival relative to their physicians, but this relationship has not been examined in patients with noncancer diagnoses. Perceptions of progn...
Article
To the Editor High levels of chronic stress are associated with an increased incidence of Mild Cognitive Impairment (MCI) and Alzheimer's disease (AD) (1, 2) and negatively impact the hippocampus, a key AD brain region. Mindfulness Based Stress Reduction (MBSR), a standardized mindfulness meditation/yoga intervention, may decrease stress/cortisol,...
Article
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Objectives: The study objectives were to determine the feasibility and effects of providing therapeutic massage at home for patients with metastatic cancer. Design: This was a randomized controlled trial. Settings/location: Patients were enrolled at Oncology Clinics at a large urban academic medical center; massage therapy was provided in pati...
Article
Full-text available
After five decades of growth that has included advances in medical education and health care delivery, value cohesion, and integration of diversity, we propose an overarching mission for academic general internal medicine to lead excellence, change, and innovation in clinical care, education, and research. General internal medicine aims to achieve...
Article
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Correspondence: Dr Nerurkar, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, YA-102G, Boston, MA 02215 (anerurka@bidmc.harvard.edu). Published Online: November 19, 2012. doi:10.1001/2013.jamainternmed.480 Author Contributions: Dr Nerurkar had full access to all of the data in the study and tak...
Article
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Among patients with end-stage renal disease (ESRD), few studies have examined the use of complementary and alternative medicine (CAM) and patients' interest in learning mind-body interventions to address health issues. We surveyed 89 adult patients (response rate 84%) at an outpatient hemodialysis center in Brookline, MA, USA regarding the utilizat...
Article
Objectives: To assess the prevalence of complementary and alternative medicine (CAM) use by U.S. adults reporting neuropsychiatric symptoms and whether this prevalence changes based on the number of symptoms reported. Additional objectives include identifying patterns of CAM use, reasons for use, and disclosure of use with conventional providers i...
Article
Although exercise is an important component of heart failure management, optimal regimens, particularly in heart failure with preserved ejection fraction (HFPEF), are uncertain. Tai chi (TC) is a mind-body exercise that may have potential benefits but has not been studied in this population. The authors randomized 16 patients with HFPEF to either 1...
Article
Full-text available
Purpose Neuropsychiatric symptoms caused by mild Traumatic Brain Injury (mTBI) are difficult to treat with standard interventions. Given such limitations, patients may choose to treat themselves with mind-body therapies. However, little is known about the use of mind-body therapies by adults with neuropsychiatric symptoms associated with mTBI. Meth...
Conference Paper
Full-text available
Purpose Physician burnout is associated with decreased wellbeing, loss of empathy, and reduced quality of patient care. Despite high rates of burnout among physician trainees, few studies have explored strategies to address this problem. We examined the skills and habits associated with decreased burnout among physicians who participated in the Hum...
Article
Full-text available
Purpose Fifty percent of adults with mild cognitive impairment (MCI) develop Alzheimer's disease (AD) within 5 years. Preliminary data suggest that mindfulness-based stress reduction (MBSR) increases gray matter density of the hippocampus, which atrophies in AD. We studied the safety, feasibility, and impact of MBSR on brain function , memory, and...
Article
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Background: Extreme temperatures have been associated with hospitalization and death among individuals with heart failure, but few studies have explored the underlying mechanisms. Objectives: We hypothesized that outdoor temperature in the Boston, Massachusetts, area (1- to 4-day moving averages) would be associated with higher levels of biomarkers...
Data
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