LEAWOOD, KS - Fourteen of the nation’s 460 accredited family medicine residencies are participating in an initiative to look at new ways to provide practice management training to personal physicians during their residencies.
The Association of Family Medicine Residency Directors, the American Board of Family Medicine, the American Academy of Family Physicians and TransforMED have launched the Preparing the Personal Physician for Practice (P4) initiative, with the belief that the model of personal doctoring based on personal revenue is exhausted.
“We don’t want to train residents to run from exam room to exam room at 12-minute intervals,” said Larry Green, MD, AAFP’s senior scholar in residence at the Robert Graham Center in Washington, D.C. Instead, he said, P4 wants to train physicians to build personal practices based around seamless, coordinated care.
Green hopes that four years from now, the program will have generated evidence that can leads to recommendations to improve all family residencies.
“The whole design is that it’s a pragmatic trial,” he said.
A research group from Oregon Health and Sciences University in Portland, Ore. will conduct evaluations of the residencies’ P4 projects.
AFMRD and the ABFM Foundation have allocated almost $1.75 million to P4. The program will probably cost around $3 million and has no built-in financial rewards for physicians, Green said.
“This is one of the most intriguing things – that there is no pot of gold at the end of the program, but (the residencies) participate anyway,” he said. “What does that mean? It means that they care.”
While there are no sign-up costs, residencies are looking at various ways to fund their goals within P4.
Some residencies have looked into development grants, Medicare’s graduate medical education funding program, philanthropy, and support from outside health systems.
Joseph Gravel, MD, residency program director at Tufts University Family Medicine Residency at Cambridge Health Alliance in Cambridge, Mass., said his P4 program is on a shoestring budget.
“We can wait three years and raise the money or we can move forward and hope we get some support down the road,” he said. “To me, it’s a no-brainer.”
As part of its P4 improvement efforts, Tufts is building a new residency center, at which they will implement group visits for patients and increase the use of information technology.
Jennifer Naticchia, MD, program director of Family Medicine Residency at Christiana Care Health System in Wilmington, Del., is hoping to enhance her residency in the areas of faculty and administrative support.
Additionally, she said, Christiana will use P4 to help make its personal physicians experts in transition of care and practice management.
“We’re hoping that graduating physicians will be able to meet their overhead and have had training in model practice starting with day one – that there will no longer be that delay,” said Naticchia.
While it’s not structured for financial payoff, P4’s focus on graduating better personal physicians has the potential to generate savings in healthcare by shifting more treatment to primary care, Gravel said.
“Frankly, the studies bear it out that the more the primary care physician handles, the more cost-effective the care is, and quality goes up, too,” he said. Improved primary care can result in decreased hospitalizations and ER visits, drastically reducing costs, he said.
“To the system, it’s extremely beneficial if this is done right,” he said.