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Research ArticleArticle

Health Is Primary: Family Medicine for America’s Health

Robert L. Phillips, Perry A. Pugno, John W. Saultz, Michael L. Tuggy, Jeffrey M. Borkan, Grant S. Hoekzema, Jennifer E. DeVoe, Jane A. Weida, Lars E. Peterson, Lauren S. Hughes, Jerry E. Kruse and James C. Puffer
The Annals of Family Medicine October 2014, 12 (Suppl 1) S1-S12; DOI: https://doi.org/10.1370/afm.1699
Robert L. Phillips Jr
The American Board of Family Medicine, Washington, DC
MD, MSPH
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  • For correspondence: bphillips@theabfm.org
Perry A. Pugno
American Academy of Family Physicians, Leawood, Kansas
MD, MPH
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John W. Saultz
Society of Teachers of Family Medicine, Leawood, Kansas, and Department of Family Medicine, Oregon Health Sciences Center, Portland, Oregon
MD
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Michael L. Tuggy
Association of Family Medicine Residency Directors, Leawood, Kansas, and Swedish Family Medicine–First Hill, University of Washington School of Medicine, Seattle, Washington
MD
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Jeffrey M. Borkan
Association of Departments of Family Medicine, Leawood, Kansas, and Department of Family Medicine, Alpert Medical School/Memorial Hospital of Rhode Island, Brown University, Providence, Rhode Island
MD, PhD
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Grant S. Hoekzema
Association of Family Medicine Residency Directors, Leawood, Kansas, Family Medicine–Mercy Hospital St Louis, and Department of Family and Community Medicine, St Louis University School of Medicine, St Louis, Missouri
MD
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Jennifer E. DeVoe
North American Primary Care Research Group, Leawood, Kansas, and OCHIN, Oregon Health Sciences University Department of Family Medicine, Portland, Oregon
MD, DPhil
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Jane A. Weida
American Academy of Family Physicians Foundation, Leawood, Kansas, Family Health Care Center, Reading Hospital Family Medicine Residency, Reading, Pennsylvania and Pennsylvania State College of Medicine, Hershey, Pennsylvania
MD
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Lars E. Peterson
American Board of Family Medicine, Leawood, Kansas
MD,PhD
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Lauren S. Hughes
Robert Wood Johnson Foundation Clinical Scholar, University of Michigan, Ann Arbor, Michigan
MD, MPH
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Jerry E. Kruse
Society of Teachers of Family Medicine, Leawood, Kansas, and Southern Illinois University HealthCare at Southern Illinois University School of Medicine, Springfield, Illinois
MD, MSPH
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James C. Puffer
American Board of Family Medicine, Leawood, Kansas.
MD
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    Figure 1

    Role definition and foil definition for the family physician.

  • Figure 2
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    Figure 2

    Implementation infrastructure of Family Medicine for America’s Health.

Tables

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    Table 1

    Task Forces of Future of Family Medicine

    Task Force 1. Identify the core attributes of family practice, reform family practice to meet consumer expectations, and determine systems of care to be delivered by family practice33
    Task Force 2. Determine the training needed for family physicians to deliver core attributes and system services34
    Task Force 3. Ensure that family physicians deliver core attributes and system services throughout their careers35
    Task Force 4. Determine strategies for communicating the role of family physicians within medicine and health care, as well as to purchasers and consumers36
    Task Force 5. Determine family practice’s leadership role in shaping the future health care delivery system37
    Task Force 6. Report on financing the new model of family medicine38
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    Table 2

    What Patients Can Expect of a Family Physician

    Give patients the care they need when they are most vulnerable
    Care for patients regardless of age and health conditions, and work to sustain an enduring and trusting relationship with them
    Be each patient’s first contact for health concerns. Address all their health concerns, and resolve most of them
    Help patients with preventing, understanding, and managing illness
    Navigate the health system with patients, including coordinating with specialists and staying connected with patients before, during, and after time spent in a hospital
    Set health goals that adapt to each patient’s needs as defined by them
    With the care team, use data and best science to prioritize and coordinate services most likely to benefit patients’ health
    Use technology to maintain and enhance access, continuity, and relationships, and to optimize patients’ care and outcomes
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    Table 3

    What Patients Can Expect of Family Physicians’ Practices

    Provide the right care, at the right time, at the right cost
    Ensure patients can be seen by their family physician or a member of the care team whenever needed
    Assist patients with all of their health care needs
    Coordinate patients’ care across settings; integrate care for acute and chronic illness, mental health and prevention; and guide access to specialist care when needed
    Organize care within the care team to meet their patients’ needs and provide continuity of care across time
    Use technology to maintain and enhance access, continuity, and relationships
    Understand the effects of the community-level factors and social determinants of health on their patients’ well-being, and identify community resources available to meet their health needs
    Care for patients in the context of their family and the ways in which the health of each family member affects the others
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    Table 4

    What Patients Can Expect of the Discipline of Family Medicine

    Family medicine’s leadership will welcome collaboration with patients, employers, payers, policy makers, other primary care professionals, mental health clinicians, and public health to enhance the value and benefits of primary care, particularly the contribution that family physicians make, in meeting the health and health care needs of people throughout the United States
    Family medicine will work to ensure that every person in the United States understands the value of and has the opportunity to have a personal relationship with a trusted family physician or other primary care professional in the context of a medical home
    Family medicine will, in collaboration with primary care partners, be accountable for increasing the value of primary care for the patients served, using specific measures to do the following:
    1. Lower the total cost of care for the patients served

    2. Continuously improve the health and quality of care of the patients served

    3. Continuously improve each patient’s experience of and access to care, emphasizing the patient’s definition of both

    Family medicine will collaborate with national stakeholders to reduce health disparities in the United States
    Family medicine will lead, through ongoing outcomes-based research, the continued evolution of the patient-centered medical home to ensure it is the best way to deliver comprehensive, patient-centered care to the patients, families, and the communities served
    Family medicine will work to ensure that the country has the well-trained primary care workforce it needs for the future through expansion and transformation of training from pipeline through practice
    To give patients the comprehensive and coordinated care and attention they deserve, family medicine commits to moving primary care reimbursement away from fee-for-service and toward comprehensive primary care payment as quickly as possible in coordination with its primary care colleagues
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The Annals of Family Medicine: 12 (Suppl 1)
The Annals of Family Medicine: 12 (Suppl 1)
Vol. 12, Issue Suppl 1
October 2014
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Health Is Primary: Family Medicine for America’s Health
Robert L. Phillips, Perry A. Pugno, John W. Saultz, Michael L. Tuggy, Jeffrey M. Borkan, Grant S. Hoekzema, Jennifer E. DeVoe, Jane A. Weida, Lars E. Peterson, Lauren S. Hughes, Jerry E. Kruse, James C. Puffer
The Annals of Family Medicine Oct 2014, 12 (Suppl 1) S1-S12; DOI: 10.1370/afm.1699

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Health Is Primary: Family Medicine for America’s Health
Robert L. Phillips, Perry A. Pugno, John W. Saultz, Michael L. Tuggy, Jeffrey M. Borkan, Grant S. Hoekzema, Jennifer E. DeVoe, Jane A. Weida, Lars E. Peterson, Lauren S. Hughes, Jerry E. Kruse, James C. Puffer
The Annals of Family Medicine Oct 2014, 12 (Suppl 1) S1-S12; DOI: 10.1370/afm.1699
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