RT Journal Article SR Electronic T1 In Search of Joy in Practice: A Report of 23 High-Functioning Primary Care Practices JF The Annals of Family Medicine JO Ann Fam Med FD American Academy of Family Physicians SP 272 OP 278 DO 10.1370/afm.1531 VO 11 IS 3 A1 Christine A. Sinsky A1 Rachel Willard-Grace A1 Andrew M. Schutzbank A1 Thomas A. Sinsky A1 David Margolius A1 Thomas Bodenheimer YR 2013 UL http://www.annfammed.org/content/11/3/272.abstract AB We highlight primary care innovations gathered from high-functioning primary care practices, innovations we believe can facilitate joy in practice and mitigate physician burnout. To do so, we made site visits to 23 high-performing primary care practices and focused on how these practices distribute functions among the team, use technology to their advantage, improve outcomes with data, and make the job of primary care feasible and enjoyable as a life’s vocation. Innovations identified include (1) proactive planned care, with previsit planning and previsit laboratory tests; (2) sharing clinical care among a team, with expanded rooming protocols, standing orders, and panel management; (3) sharing clerical tasks with collaborative documentation (scribing), nonphysician order entry, and streamlined prescription management; (4) improving communication by verbal messaging and in-box management; and (5) improving team functioning through co-location, team meetings, and work flow mapping. Our observations suggest that a shift from a physician-centric model of work distribution and responsibility to a shared-care model, with a higher level of clinical support staff per physician and frequent forums for communication, can result in high-functioning teams, improved professional satisfaction, and greater joy in practice.