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Young Doctors in Love … With Primary Care!

Posted by John McDonough  September 12, 2012 09:12 PM

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I get asked what's best about teaching at the Harvard School of Public Health. Here's an example.

Last spring, three of my public health students, all medical students getting their masters in public health (MPH) degree before finishing their final year of medical school, sent me a draft of an article they had written. The article detailed their excitement at the prospect of specializing in primary care, not traditional primary care, but the new primary care now being developed in innovative medical homes and accountable care organizations across the U.S.

I was surprised and thought their proposed article was fantastic and important, a rationale for why primary care may just be the most exciting place to be in medicine in the near future. I gave them some ideas on how to improve it, and urged them to think big, say, the New England Journal of Medicine, one of the most prestigious medical journals in the world. And now...

In the September 6 issue, NEJM published the essay by my three students: Kathleen A. Barnes from Boston, Jason C. Kroening-Roche from Portland Oregon, and Branden W. Comfort from Kansas. The essay is titled: The Developing Vision of Primary Care, and here is a brief excerpt about the new role of primary care physicians:

"Physicians' jobs would change as well, as they took on new roles and shed some old ones. No longer would the physician run from room to room, pushed by the clock and the paycheck. Reimbursed through global payments linking hospitals to primary care practices, the physician, too, would have a financial incentive to keep patients healthy and to prioritize services with that goal in mind. The physician would now see fewer patients in the office, leaving time for responding to questions e-mailed by patients the previous night and for calling those who would otherwise be headed to the emergency department. Clinic visits would ideally be nearly twice as long as they are now, since physicians would focus on patients with complex conditions and would have time to address care coordination, answer patients' questions fully, and understand their personal health goals in order to guide treatment. Timely follow-up after hospital discharge would be a high priority, and some visit slots would be reserved for that purpose. Savings from reduced hospitalizations could be reinvested in these high-value primary care services."

There is a revolution brewing in medical care and in primary care especially. It's exciting to see our young and new physicians embracing it.

This blog is not written or edited by Boston.com or the Boston Globe.
The author is solely responsible for the content.

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About the author

John E. McDonough is a professor of practice at the Harvard School of Public Health. He is the author of the book “Inside National Health Reform”, published in 2011 by More »

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