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The Richard and Hinda Rosenthal Lecture 2007 Transforming Today's Health Care Workforce to Meet Tomorrow's Demands (2008) / Chapter Skim
Currently Skimming:

Kevin Grumbach, M.D.
Pages 5-12

The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.


From page 5...
... Human resources, in my mind, are the single most critical ingredient in the health care system, yet health policy discussions often give short shrift to this issue. Those of us who do research and policy work in health workforce issues are partly to blame for this.
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From page 6...
... The IOM's Committee on the Future of Primary Care defined primary care as "the provision of integrated accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community." Primary care is provided by family physicians, general internists, general pediatricians, nurse practitioners, physician assistants, and others who work in the primary care sector. These clinicians are responsible for delivering accessible first-contact care; providing continuity of care through ongoing relationships; comprehensively addressing the majority of patient needs, whether they are urgent care problems, chronic care needs, preventive care needs, or psychosocial needs; and integrating specialty referrals and ancillary services to provide patient-centered, whole-person care.
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From page 7...
... The traditional response would be to declare that there is a shortage of primary care physicians and that the nation needs a much greater number of primary care physicians in order to reduce the typical panel size to a level well below 2,000 patients per each primary care clinician. This policy option is in fact being played out in a somewhat perverse way in the United States today by what is known as boutique primary care medical practices.
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From page 8...
... Let me give you an example of how health information technology could transform preventive service delivery in primary care and make better use of precious physician and other clinician time. Here is a typical visit with prevention content as it transpires in the traditional family care practice, which may be disturbingly like your experiences as patients or clinicians: A patient schedules an appointment with a physician, nurse practitioner, or physician assistant.
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From page 9...
... It is not going to be a registered nurse; it is going to be a medical assistant. Although medical assistants usually join a practice after having received only a rudimentary level of vocational training, they are the main staff members in most primary care practices.
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From page 10...
... About 20 years ago, Harold Wise wrote a book called Making Health Care Teams Work, and he pointed out that football teams spend the whole week practicing for that 3-hour game. He observed that you are lucky to get teams in primary care to spend 2 hours a year practicing for something that they work on 40 hours a week.
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From page 11...
... But I think that simply seeing this as a problem of numbers fails to appreciate the most important challenge for workforce policy, which is the theme of this session: namely, how to transform and rethink our practice models to create a much more efficient, productive, and effective model of health care. While we need some additional investment in the educational pipeline to produce an adequate supply of primary care physicians, perhaps even more compelling is the need for payers and purchasers to invest in innovative practice models that can deploy primary care clinicians more productively.
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From page 12...
... She is a prolific writer and serves on the editorial boards of the Journal of Nursing Scholarship and Nursing and Health Policy Review. She is a member of the IOM and the American Academy of Nursing.
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Key Terms

  • medical assistant
  • chronic care
  • care physicians
  • care services
  • care clinician

  • care physician
  • care clinicians
  • medical assistants
  • physician workforce
  • practice models

  • practice primary
  • delivering primary
  • existing primary
  • preventive care
  • care practice

  • care practices
  • care model
  • care sector
  • care visit
  • care careers

  • electronic medical
  • family physician
  • physician assistants
  • precious physician
  • workforce policy

  • preventive services
  • policy option
  • pneumococcal vaccine
  • nurse practitioners
  • team models


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