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.