Transforming Primary Care Fellowship



Developing leaders for
the future of primary care







SUSAN SNYDER, MD at ssnyder@g.ucla.edu



The Harbor-UCLA Transforming Primary Care Fellowship prepared recent residency graduates to lead, teach, and implement new models of primary care with a special focus on care for medically underserved populations.






Don LassusIt has been a very good year of learning and stretching myself in new and necessary ways to prepare me for leadership, even if it was uncomfortable at times. My personal growth was tremendous, and would never have happened without the level of direct mentoring in the fellowship.  I feel so proud that our clinic teams were able to achieve so much, and priviledged to have worked with Caitlin, David, Dr. Snyder, Dr. Gutierrez, Dr. Robinson, and Michele. The fellowship group was mutually supportive and a source of resilience admist tough challenges.  Most concretely, I practiced many styles of leadership: affiliative, authoritative, democratic, mentoring/coaching. I learned the art of leading a meeting, how to back channel, get buy-in, communicate in different modalities, try to make changes stick. I also learned the basic requirements for NCQA PCMH recognition. I learned Model for Improvement/ PDSA and Lean techniques for QI work, and learned the basics of how to precept residents. All in all, I feel prepared to take on a leadership role in any practice setting, and would feel comfortable in an academic family medicine department. It was a good year, and I would recommend it to any current Harbor resident who has a tolerance for disorder, and chaos, but wants to learn and has a hopeful attitude that change can and will happen.                                                   Don Lassus, MD,  2013-14 Fellow



Brief program description

This year long faculty development fellowship provided recent residency graduates with training and mentoring to become leaders for the future of primary care.


The program included:

  • Clinical practice in a safety net clinic that is undergoing transition to a PCMH model.
  • Teaching Harbor-UCLA family medicine residents and medical students from UCLA.
  • Weekly seminars that cover teaching skills, leadership, team dynamics, quality improvement, new models of primary care, organizational transformation, and more…
  • Mentored experience leading a multi-disciplinary practice and QI team.
  • An individual project related to new models of primary care.

The Harbor-UCLA Transforming Primary Care Fellowship represents the most recent phase of a cutting edge faculty development fellowship started in 1997 by the current director, Dr. Susan Snyder, who also serves as vice chair of the Department of Family Medicine at Harbor-UCLA Medical Center. More than 60 graduates have completed the fellowship. Many have gone into residency teaching and/or administrative roles in health care, especially within the public and non-profit safety net clinics of Los Angeles County.


The primary care landscape is changing rapidly. As a result of rapid proliferation of scientific medical knowledge and evidence –based treatments and prevention, the workload of primary care physicians has increased dramatically in the past 30 years.


In 2004, the Future of Family Medicine report, published in the Annals of Family Medicine, defined the characteristics of the “New Model of Care”. In 2007, those characteristics were incorporated into the Joint Principles of the Patient-Centered Medical Home that was endorsed by major primary care organizations representing several hundred thousand physicians nationwide. The National Committee for Quality Assurance (NCQA) developed standards for patient-centered medical home accreditation of primary care practices in 2008. Since then, there has been a burst of creative, innovative activity in primary care with many organizations demonstrating improved outcomes, decreased hospitalizations and ER visits, and cost savings. The passage and implementation of the Affordable Care Act (ACA) has resulted in additional opportunities and challenges for primary care.


Many residents currently in training have not yet experienced the new model, yet they will be called on to practice in and lead in organizations that are either in the midst of or planning innovative changes. As team-based care becomes the norm, the role of physician is changing and new skills are needed. Leading change and practice transformation requires a working knowledge of quality improvement, creative and engaged leadership, an understanding of how organizations change, and more. The evidence base regarding the outcomes of new models of care and practice transformation is expanding rapidly.


Located in southern Los Angeles, Harbor-UCLA Medical Center is the county’s second largest public hospital. The HUCLA Family Health Center (FHC) is the ambulatory practice site for 36 residents; plus residency faculty; with 28,000 patient visits yearly, the FHC has 26 exam rooms, an on-site pharmacy and a procedure suite.  Our patient population is 51% Latino, 20 % African American, and 46% covered by county programs for the uninsured.   Transformation to a patient centered medical home is currently underway.  County wide implementation of an electronic health record throughout the all of the facilities of the Los Angeles Department of Health Services of is scheduled to begin at Harbor this summer.


Harbor-UCLA Family Medicine website: http://harborfm.com


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