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- Page navigation anchor for Re:Re:The problem of self-referential modelsRe:Re:The problem of self-referential modelsShow More
Go to the search box for Family Practice Management on the AAFP website, plug in "Doug Iliff," and click on "Solo Practice," then one of the "Making It" links. Most of my "secrets" are hiding in plain sight somewhere in 18 months of blogging. After that, if you have questions, call me. All the numbers are at doctoriliff.com. Short answer: my long- time staff and I are a close-knit team with well-differentiated roles....
Competing Interests: None declared. - Page navigation anchor for Re:The problem of self-referential modelsRe:The problem of self-referential models
As a resident about to enter practice, I would definitely be interested in hearing more specifics about how you are able to achieve this kind of quality without subscribing to the team model.
Competing interests: None declared
Competing Interests: None declared. - Page navigation anchor for Education for Team-Based Task DelegationEducation for Team-Based Task DelegationShow More
"Estimating a Reasonable Patient Panel Size for Primary Care Physicians With Team-Based Task Delegation" provides a path to solving in part the impending shortage of primary care providers. Although there has been progress in expansion of the primary care clinician workforce, it appears this will be insufficient in meeting future needs. Allowing members of the clinical team to work to the "top of their license" through...
Competing Interests: None declared. - Page navigation anchor for Great start to an important dialogue about capacityGreat start to an important dialogue about capacityThis article does a nice job of beginning to quantify the benefits of delegation. Although the theoretical approach seems sound there are a few signs from the current reality that will need some more investigation. The most critical problem with this research is that it is firmly grounded in the current fee-for-service, visit based model. All work seems to be office based, face-to-face and visit related. Current data shows that...Show MoreCompeting Interests: None declared.
- Page navigation anchor for A good quantitative stepA good quantitative stepShow More
I have disagreed with some of the claims of the Bodenheimer, et al. articles in the past regarding the panacea of team-based primary care. However, this one, assuming that the models that form the basis of this study are a reasonable facsimile to reality, struck me as both reasonable and thoughtful. Clearly, we must evaluate innovative models for the delivery of primary when faced with the conundrum of high demand and...
Competing Interests: None declared. - Page navigation anchor for At last some science behind panel sizeAt last some science behind panel sizeShow More
I frequently comment in presentations that there is no science behind primary care panel size. The historic 2000-2500 patients comes from a time in general practice when most patient care was common acute problems. Since then, comprehensive prevention and the management of chronic illness has come to dominate our work. We seek to practice the biopsychosocial model. Therapists with active panel sizes of 20-30 patients wond...
Competing Interests: None declared. - Page navigation anchor for task delegationtask delegationShow More
I read through this article eagerly to see if it contained any models for the use of PAs or NPs. It seems as though they were considered as equivalent to physicians and no differences or allowances for collaboration, supervisory time or consultation were provided. I agree that these have not been well studied but would like to present another model.
I agree that PAs/NPs with their own panels would assume s...
Competing Interests: None declared. - Page navigation anchor for The problem of self-referential modelsThe problem of self-referential modelsShow More
I am a solo family physician in a mid-sized midwestern city. My patient panel size is somewhere between four and five thousand; in private practice it's hard to know for sure. They are free to roam, based on changes in occupation and insurance. I just finished the survey for the NCQA diabetes recognition program; my score was 90%, failing only the measure of documented dilated eye exams. Frankly, I don't push that har...
Competing Interests: None declared.