October 28, 2019: What is Advanced Primary Care?

Please find below some thoughts on what Advanced Primary Care includes.

by Dr. Scott Conard

These values and principles are written to include all that provide primary care – from rural health, community centers, standard fee for service or prepaid practices. Also, the ability to include this range of services assumes the presence of an effective team of professionals and appropriate financial support to underwrite the costs.

After reading tell us your thoughts…

Core Values

  • The primary care organization’s leadership has a clear understanding of their “WHY” and actively encourages staff and clinicians at all levels to discover and recommit to their “WHY” at regular intervals.
  • An adaptive capacity, at the individual/team/organizational level, that encourages the effort to improve care and the responsiveness of the organization to the people and communities served.
  • A commitment to protect people from the medical industrial complex in America today where “more care” is being delivered, driven by a fee for service system, that is harmful – financially, if not medically.

Service Delivery

The processes which each practice will decide the best way to incorporate into their operations.

  • Access (Multiple pathways for FPs to be available) Making oneself/the practice accessible throughout the ecology of care. (Kerr White)
  • Acute care (for most of the problems that patients need assistance) If possible, a way of offering urgi-care services in a way that brings a patient into contact with the primary care office.
  • Routine use of the HOPE note (see How Healing Works by Wayne Jonas, MD for more details).
  • Chronic disease management including disease reversal (especially with Self Care – diet, activity, sleep, and increased health literacy).
  • A regular health exam driven by a whole person orientation driven by the risk and to build and maintain a caring relationship (by age group)
  • Hi-risk patients are identified and proactively engaged to prevent and minimize complications.
  • Deprescribing as a core service
  • Lifestyle medicine orientation with a focus on promoting healthy lifestyle and wellness
  • If hospitalized the primary care team stays in touch with the patient and the patient’s caregivers
  • Navigators who are members of the team to help people manage the referral process (managing the referral process and pruning your tree)
  • Behavioral/mental health services available in the practice, and
  • A practice that actively seeks to identify the lowest cost providers for labs and special studies and especially to gain discounted cash prices for their patients.