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Primary care is an essential and foundational part of our healthcare system, which is vital to transforming healthcare in the US to a just, equitable, affordable and accessible system. Through the advocacy of ACP in collaboration with other organizations, and through the lens of the COVID - 19 pandemic, attention has been increasingly focused on how to support primary care physicians and practices. In this episode we talk with two amazing champions of primary care, Dr. Darilyn Moyer and Dr. Sue Bornstein, and of transformation of the US healthcare system about how robust, well supported primary care can address health disparities and ensure the health of our communities.
Link for CME credit coming soon! |
Show Notes
[0:00-3:00]:
Co-host introductions
[3:00-6:59]
-Dr. Moyer Introduction
-Dr. Bornstein Introduction
[7:00-13:20]
-Be the Change Segment:
-Dr. Moyer describes her experience being inspired by a physician when she fell ill as a kid, and how she pursued her career from then. She saw the poverty and lack of healthcare struck in Pennsylvania, and became engaged in helping the community through providing medical services.
-Dr. Bornstein describes her experience growing up in segregated Texas, and how she was inspired by her physician father who advocated equality for all, and carried that same attitude through her medical journey, particularly in El Paso where she was immersed in diversity.
[13:21-22:18]:
Paper mentioned: https://www.acpjournals.org/doi/10.7326/M20-7381
How can Primary Care Physicians, particularly in light of COVID, help with inequalities in health care?
-Dr. Moyer:
-Primary care has declining state investments, yet remains a majority of patient reasons for visiting.
-Despite struggles with COVID, physicians were able to deploy tele-health,infection control protocols, and PPE
-Primary care pivoted to testing, and made sure that there was enough every-day patient care and connections
-Building vaccine confidence
-Dr. Bornstein:
- She needs to see movement toward either a prospective payment model or some type of value based payment system where we don't have to rely solely on seeing patients (no more fee-for-service model).
- Funding needs to change
-Be careful of telehealth due to no continuity of care by physicians.
[22:19 - 28:33]:
What are the lessons that we can and should learn beyond the financial stresses about the challenges increasingly facing primary care teams and underserved areas?
-Bornstein: Address social determinants and address them in a way that does not increase administrative burden. We must educate ourselves about what the situation is and what the patient community is- should not be a physician-centric issue. We must advocate for patients.
-Dr. Parsley mentions improvements her clinic is doing for understanding patient’s situations
-Dr. Moyer says how the dollars need to go to the right places in healthcare, where we pay for value and outcomes. Also need to account for risk-adjustment.
[28:34-36:42]
-How can primary care address health disparities and health inequalities, particularly in the context of culturally competent linguistically accessible care while addressing social determinants?
-Dr. Moyer: primary care is in a position to help deal with tattering social infrastructure- hospitals and healthcare systems need to connect with the community. She references a robust community health worker program in her area.
-Dr. Bornstein: She states we should all keep on learning and learn about cultural differences for better health care. Segregation and other financial short-comings are prevalent and we must educate ourselves and advocate for patients.
[36:43-44:50]
-Report mentioned on implementing high-quality care
-Dr. Moyer’s comments on the paper:
- They need to move primary care from a fee for service volume based system to one that is a much more prospective payment system that recognizes a lot of care isn’t just seeing a physician face-to-face.
-They need to streamline seamless interconnected communication systems- one of the premises of the report was to ensure information systems are synchronized.
-Healthcare is suffering and we need to work together to improve the quality of healthcare.
-Dr. Bornsteinn talks about how her paper released in January 2020 aligns with much of the report.
[44:51-53:00]
-CDC definition of social determinants of health
-How can PCPs address social determinants?
-Dr. Bornstein:
- Discusses her paper on addressing social determinants.
- Discusses the importance of the ACP’s statement on being an anti-racist organization.
-Dr. Moyer:
-We must leverage the whole team, skills, resources and community health group. Must have diverse and inclusive groups.
[53:01-59:33]
-How do we remove those barriers and how do we support people from marginalized, underrepresented groups going into primary care medicine, particularly, internal medicine?
-Dr: Moyer: Mentions the importance of diversity and helping those from marginalized groups. Also she mentions Tammy Lin’s program, Med Mindset. States we need to be working with medical organizations of color.
Dr. Bornstein: We need to our best to have more marginalized groups in medicine.
[59:34-1:05:50]:
-COVID paper mentioned from the ACP that Dr. Bornstein authored.
- Gender Paper mentioned that Dr. Moyer and Dr. Bornstein worked on
-Dr. Bornsteinn talks about the importance of universal coverage
-Dr. Moyer furthers Dr. Bornsteinn’s point and says we could do it through a public, pluralist or single-payer system. Also we need to lessen paperwork to decrease administrative burden. We need to be able to fund GME properly and train medical students properly.
-Dr. Bornstein continus and states that it is important we strengthen our public health infrastructure.
[1:05:51-1:10:00]
Conclusion and outro
Co-host introductions
[3:00-6:59]
-Dr. Moyer Introduction
-Dr. Bornstein Introduction
[7:00-13:20]
-Be the Change Segment:
-Dr. Moyer describes her experience being inspired by a physician when she fell ill as a kid, and how she pursued her career from then. She saw the poverty and lack of healthcare struck in Pennsylvania, and became engaged in helping the community through providing medical services.
-Dr. Bornstein describes her experience growing up in segregated Texas, and how she was inspired by her physician father who advocated equality for all, and carried that same attitude through her medical journey, particularly in El Paso where she was immersed in diversity.
[13:21-22:18]:
Paper mentioned: https://www.acpjournals.org/doi/10.7326/M20-7381
How can Primary Care Physicians, particularly in light of COVID, help with inequalities in health care?
-Dr. Moyer:
-Primary care has declining state investments, yet remains a majority of patient reasons for visiting.
-Despite struggles with COVID, physicians were able to deploy tele-health,infection control protocols, and PPE
-Primary care pivoted to testing, and made sure that there was enough every-day patient care and connections
-Building vaccine confidence
-Dr. Bornstein:
- She needs to see movement toward either a prospective payment model or some type of value based payment system where we don't have to rely solely on seeing patients (no more fee-for-service model).
- Funding needs to change
-Be careful of telehealth due to no continuity of care by physicians.
[22:19 - 28:33]:
What are the lessons that we can and should learn beyond the financial stresses about the challenges increasingly facing primary care teams and underserved areas?
-Bornstein: Address social determinants and address them in a way that does not increase administrative burden. We must educate ourselves about what the situation is and what the patient community is- should not be a physician-centric issue. We must advocate for patients.
-Dr. Parsley mentions improvements her clinic is doing for understanding patient’s situations
-Dr. Moyer says how the dollars need to go to the right places in healthcare, where we pay for value and outcomes. Also need to account for risk-adjustment.
[28:34-36:42]
-How can primary care address health disparities and health inequalities, particularly in the context of culturally competent linguistically accessible care while addressing social determinants?
-Dr. Moyer: primary care is in a position to help deal with tattering social infrastructure- hospitals and healthcare systems need to connect with the community. She references a robust community health worker program in her area.
-Dr. Bornstein: She states we should all keep on learning and learn about cultural differences for better health care. Segregation and other financial short-comings are prevalent and we must educate ourselves and advocate for patients.
[36:43-44:50]
-Report mentioned on implementing high-quality care
-Dr. Moyer’s comments on the paper:
- They need to move primary care from a fee for service volume based system to one that is a much more prospective payment system that recognizes a lot of care isn’t just seeing a physician face-to-face.
-They need to streamline seamless interconnected communication systems- one of the premises of the report was to ensure information systems are synchronized.
-Healthcare is suffering and we need to work together to improve the quality of healthcare.
-Dr. Bornsteinn talks about how her paper released in January 2020 aligns with much of the report.
[44:51-53:00]
-CDC definition of social determinants of health
-How can PCPs address social determinants?
-Dr. Bornstein:
- Discusses her paper on addressing social determinants.
- Discusses the importance of the ACP’s statement on being an anti-racist organization.
-Dr. Moyer:
-We must leverage the whole team, skills, resources and community health group. Must have diverse and inclusive groups.
[53:01-59:33]
-How do we remove those barriers and how do we support people from marginalized, underrepresented groups going into primary care medicine, particularly, internal medicine?
-Dr: Moyer: Mentions the importance of diversity and helping those from marginalized groups. Also she mentions Tammy Lin’s program, Med Mindset. States we need to be working with medical organizations of color.
Dr. Bornstein: We need to our best to have more marginalized groups in medicine.
[59:34-1:05:50]:
-COVID paper mentioned from the ACP that Dr. Bornstein authored.
- Gender Paper mentioned that Dr. Moyer and Dr. Bornstein worked on
-Dr. Bornsteinn talks about the importance of universal coverage
-Dr. Moyer furthers Dr. Bornsteinn’s point and says we could do it through a public, pluralist or single-payer system. Also we need to lessen paperwork to decrease administrative burden. We need to be able to fund GME properly and train medical students properly.
-Dr. Bornstein continus and states that it is important we strengthen our public health infrastructure.
[1:05:51-1:10:00]
Conclusion and outro
