From the Executive Director
Dear Supporters, I joined Primary Care Progress (PCP) because I believed we could build a new generation of leaders and transform primary care. That belief is now coming into focus, as we see a new primary care community growing, and change happening on campuses, in clinics and in health systems nationwide—and it could not come at a better time. Our country is at a historic moment, with more Americans than ever searching for a regular source of comprehensive, high-quality, affordable care. To meet this unprecedented demand, we need the best and brightest health professional trainees choosing careers in primary care. Unfortunately, many of our nation’s future health professionals continue to be discouraged from pursuing a career in primary care. They train in single-profession silos, and fear a future of care that is dictated by forces unrelated to their patients’ needs. The academic institutions that train future health professionals are not producing enough primary care clinicians. In addition, they provide training that is misaligned with the skills needed in today’s practice. To address these chronic problems in the health care system, Primary Care Progress adopts an innovative strategy that is locally driven, community-oriented, and arms students with the leadership skills they need to be advocates for change in their education and future primary care practice. Our community of leaders is taking action to create real change and provide better care for patients. I believe in primary care because I get to spend my days working with committed, brilliant, and determined primary care trainees and clinicians. As they transform their local communities, they energize a national movement and give me great hope for our future.
Melissa Gillooly Executive Director
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Primary Care Progress
Our mission is to revitalize primary care to meet the health needs of Americans by developing leaders, building interprofessional communities, and advancing innovations in training and care delivery. It is an exciting time for primary care, as new models of care delivery that function better for patients, providers and payers are being implemented at clinics across the country. For the most part, it has been a quiet movement. Many of these innovations have not been shared widely with the primary care community—certainly not with the next generation of primary care providers. Our role at PCP is to bring innovation to the forefront, and make students and trainees aware of the role they can play in transforming primary care delivery. Primary Care Progress was founded on the belief that education, collaboration, and collective action can build a new and brighter future for health care in America, with primary care at its foundation.
What is Innovation? Innovation occurs when we break free from old ways of thinking and embrace more effective methods of solving a problem or meeting a need. At Primary Care Progress, we believe creative thinking is essential to transforming primary care. Innovation is the collaborative care model, Project Echo, that uses technology to connect primary care providers with a multidisciplinary specialty team.
We bring together an intergenerational and interdisciplinary community of students, clinicians, educators and advocates. We are physicians, nurse practitioners, registered nurses, physician assistants, pharmacists, social workers, patients, and advocates bound together by our commitment to transform how health professionals are trained, and how patients are cared for. Through our chapters, leadership training, Clinical Innovation Network and advocacy campaigns, we work to transform primary care, build leadership, and provide exposure to cutting-edge innovations in patient care.
Innovation is the redesigned team structure implemented by Iora Health so all members of the care team can collaborate to deliver services their patients most need and value.
PCP is the heart of a new grassroots movement that incorporates the ideas and energy of trainees and empowers them to build new communities and make change at their local academic institutions. Transforming primary care is no small task, but by working together, building partnerships and sharing information and resources, we can build a new generation of primary care clinicians and leaders with the vision, courage and capacity to make that transformation happen.
@ 60 million
Americans lack access to primary care
Innovation is one of the things that unites the PCP community. It is what a new generation of leaders has in common as they increase the pace of change and ensure the best care possible for patients.
supply
1 in 5
sick people visit the ER for care they could have received from a primary care provider
1963
2013
demand
65,000
Estimated shortage of primary care physicians the US will face by 2025
50 years ago, half the doctors in America practiced primary care. Today, fewer than 1 in 3 do. Annual Report 2013
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The Spirit of Collaboration in Colorado There is nothing more energizing than watching a community come together, especially when it is guided by a new generation of leaders. That is what I experienced in Aurora, Colorado last fall, at a gathering organized by Joe Johnson, an Internal Medicine resident and leader of the PCP chapter at the University of Colorado. The evening brought together trainees, clinicians, and advocates to share strategies to effect change at their local institution. The animated conversation centered on remedying the historical disconnect between the health needs of the local community and the output of the academic institution. The group talked about finding concrete ways to not only engage the students and resident physicians in ongoing clinical and community service activities, but to ensure their training and education would prepare them to provide the type of primary care the community needed. The brainstorm harnessed the energy of the trainees and the expertise of the seasoned advocates. By pooling their resources, contacts, and experience, this new team created a strategy to build relationships and partnerships to attain a concrete goal: establishing a new student-run clinic in a nearby, underserved community. As the mediators between the Internal Medicine Department at University of Colorado and other key stakeholders from the local community, the PCP chapter was playing a key role in creating real, on-the-ground change. Throughout the evening, I was struck by the interprofessional nature of the group—medical students, nursing students, family medicine and internal medicine resident physicians, a nurse practitioner and several public health advocates—and by the talent and promise of a new leader: Joe. Joe brought this team together and facilitated the discussion, directing broad passion into specific goals and actions. For me, what was profound about that evening in Colorado was seeing the future of primary care first-hand. It is what I saw in Joe, and see in so many others like him across the country—a collaborative and community-oriented spirit that forecasts a very bright future for primary care.
Andrew Morris-Singer, MD President and Founder Joe Johnson (center) and members of the Colorado chapter’s leadership team.
“There are a tremendous number of health care trainees across the nation who share my spirit and passion to advance the state of primary care. If we work together and lead by example, we can make an indelible impact on the future of modern medicine and increase patient satisfaction and improve health care outcomes.” Andrew Udkovich, RN Pediatric Nurse Practitioner Student University of Rochester Chapter Leader 3 |
Primary Care Progress
University of Rochester Chapter Leaders. Photo courtesy of University of Rochester Medical Center
Our Community represents all levels of training and medical professions, and is bound together by a common value—better health care for patients. Together, we are reshaping primary care delivery in America. One of our proudest achievements in 2013 is the role we played in building community within a siloed primary care constituency. For us, bringing people with shared values together is always the first and most important step in creating meaningful change. PCP’s community takes many forms, through our chapters, Clinical Innovation Network, in-person trainings, and even online. Through these outlets, we have seen everything from deep discussions to the formation of interprofessional collaborations. When PCP was founded, we understood the power of individuals coming together in teams to create change. We knew that the key to progress in primary care education reform would depend on building teams of passionate primary care trainees at institutions across the country. PCP’s chapter network is the heart of a growing primary care community. In 2013, we welcomed 12 new chapters, for a total of 35 chapters across the country. Though PCP’s first chapter was at a medical school, a PCP chapter today is more likely to reflect the practicing interprofessional primary care community, at schools that educate physicians, nurse practitioners, physician assistants, pharmacists, and public health professionals. Creating community is not easy, and runs counter to the “lone ranger” approach health professional trainees are typically taught. By getting involved in chapter leadership and local advocacy, trainees can learn the very skills they will need to build and sustain new clinical teams, a necessary step to address mounting care needs. Nearly 200 health professional trainees are PCP chapter leaders today. These inspired trainees have taken on local goals such as creating rotations in advanced primary care models or
35
chapters
interprofessional learning. Together, they are building momentum to take on the larger issues of national medical education reform. Our local chapter leaders have the freedom to tackle the specific goals their chapters have identified. They also have the support of PCP’s national team as well as passionate colleagues around the country. Building on the strength of our chapter network, we use our online presence to leverage the power of the thousands of atlarge primary care advocates, who identify with the movement to revitalize primary care, but are not based at academic institutions. Through our social media channels, websites, Clinical Innovation Network, and our Progress Notes blog, we strive to create an online space for the primary care community to share experience, insight and perspective. This community continues to flourish. In 2013, PCP’s social media presence swelled with new members and supporters, our email list doubled, our Twitter following tripled and website visits soared. Through this online community, we’ve watched robust online discussions unfold about the state of primary care and the changes we need to make in our health care system to restore primary care as a valued foundation.
2,696 online community
members
195
chapter leaders Annual Report 2013
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Creating leaders for a stronger primary care community How do we ensure that our primary care workforce, present and future, is fully prepared to manage the health care needs of their communities? PCP’s signature leadership training program, a unique approach in the academic health environment that impresses on trainees the skills of interprofessional team building, change management, and effective communication, is our solution. At the heart of PCP’s leadership training is a focus on creating stronger leaders among health care trainees and clinicians, enabling them to be better advocates for their teams as well as their patients. As primary care delivery continues to evolve, PCP-trained leaders will be equipped with the confidence and tools to adopt and promote clinical changes that will lead to lower costs and better patient care. Of the trainings we conducted in 2013, three efforts highlight PCP’s broad reach and impact in the primary care community: Second Annual Gregg Stracks Leadership Summit The 2013 summit brought together an interprofessional group of 70 trainees and activists (59 participants from 22 chapters, as well as 11 coaches) to advance primary care at the local and national level. The two-day, intensive skills-building training focused on communication, building teams, and strategy. It challenged participants to connect their personal narratives and values with improving patient care. The summit featured an inspiring keynote address by Dr. Claudia Fegan, past president of Physicians for a National Health Program and executive medical officer for Illinois’ Cook County Health and Hospital System. To foster a greater sense of community, the summit also provided an opportunity to network with other participants and meet some of the most prominent primary care clinical innovators in the field.
“The Leadership Summit is a terrific and very important program to develop leaders for transformation of primary care and of health care overall. It is especially exciting to see an interdisciplinary team of energetic students and residents working together to create the future!” Michael Magill, MD Dept. of Family & Preventive Medicine University of Utah
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Primary Care Progress
Leadership Training
nursing
medicine
pharmacy
public health
engaging 211 trainees, clinicians, & faculty in...
physician assistant
16 leadership trainings
Clinical Innovation Network Network Members 928
In 2013, the PCP national team visited chapters around the country, leading trainings on team-building and community advocacy at Baylor College of Medicine, the University of Utah, the University of Rochester, and the University of Southern Maine. These trainings have been well-received by local communities and PCP was recently honored with the Connecticut Center for Primary Care’s Student Leadership Award for our work on mentoring, advocacy, and promoting team medicine. Coaching Network
“The sessions led by PCP were the most provocative and effective facilitation we’ve ever had at our annual residency retreat. It had the magical combination of both building relationships between our residents and faculty as well as meta-teaching the skills of how leaders can give space and structure to teach storytelling that deliberately builds relationships which in turn dramatically improves the function of teams.” Gregory Sawin, MD, MPH Program Director Tufts University Family Medicine Residency
PCP’s Coaching Network provides a directed leadership opportunity for chapter members, who receive training and support from the PCP National Team, and go on to provide trainings in team-building and community outreach to their local peers and others across the country. To date, we have worked with 11 coaches who, as chapter leaders, engage, recruit and train other chapter members. Unique among PCP’s training efforts, the coaching network provides these emerging leaders with a space to have frank conversations about the challenges and opportunities of leadership, as well as to learn from each other. As we work to advance our mission, these coaches, and those who will follow them, are key to spreading the message and providing skills training to an increasingly larger constituency.
Spreading Innovation
237 2012
Chapter Visits and Regional Trainings
2013
10
webinars Residency Training for Tomorrow’s Physicians | Primary Care Past, Present, and Future | Student-Run Free Clinics | Mental Health and Primary Care | Health Coaching | Direct Primary Care | Medical Education for a Transforming Health System | Primary Care and Specialty Collaboration | Improving Workflow and Empowering Patients | The New Face of Primary Care
A virtual, nationwide collaborative that highlights innovations in primary care, PCP’s popular Clinical Innovation Network, or CIN, is a monthly webinar series that brings the primary care community together to learn about new approaches to care delivery, training, and patient engagement. While these new models improve quality of care and reduce costs, most have not been formally integrated into curriculum at institutions of medical training. The CIN has filled a void in the collaboration and sharing of ideas in the greater primary care space, and attempts to bridge the disconnect between formal medical training and the real-life innovations taking root in clinics around the country. The webinars are typically moderated by a trainee. The interactive format offers the opportunity for shared learning as well as insight from national leaders in primary care innovation. The network has grown this past year from just over 200 to nearly 1,000 members, with each new webinar breaking previous attendance records. Annual Report 2013
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Telling the true story of primary care At PCP, rather than seeing primary care as a broken career path, we see potential, inspiration and a bright and rewarding future. We use media strategically to amplify the many voices we hear—at institutions, in clinics, at conferences and trainings. PCP uses online tools such as blogs, videos, photos, social media, presentations, and webinars, to leverage the power of our community and to facilitate strategic offline action. PCP strives to show a very different side of primary care than most Americans know, one of power and potential. We believe that by sharing stories, we share values and build power. It is why we share the stories of primary care leaders like Dr. Krisda Chaiyachati, an internal medicine resident at Yale who combined the leadership training he received at the 2013 Gregg Stracks Summit with his experience providing medical care in South Africa to improve the distressing state of patient-provider relationships in this country. Krisda and the Yale chapter launched a campaign in the fall of 2013 to gather support for a patientcentered medical home rotation at Yale. By sharing stories like Krisda’s, we hope to clear the airwaves of the myths that have surrounded primary care for too long, replacing them with real-life stories of change, courage, and highquality care. Our blog, Progress Notes, continues to gain depth, voices and popularity. It is a unique place for representing the various primary care perspectives online.
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“
Primary Care Progress has given me hope. My frustrations and fears have been replaced by optimism and a strong conviction that by working together we can improve interdisciplinary education and practice, bring justice to care delivery and access, and establish primary care as the backbone of a thriving American health care system.
”
Laura Roberts, RN Nurse Practitioner Student University of Southern Maine Chapter Leader
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Above: The first image in PCP’s campaign to highlight inspiring individuals in primary care practice.
Primary Care Progress
I have discovered in PCP an additional powerful channel to influence change. Our chapter is already contributing to shaping the landscape of Yale-New Haven Hospital’s acquisition of a nearby community hospital. We are young and we will make mistakes, but we are energized and passionate about writing the story of primary care at Yale.
”
Krisda Chaiyachati, MD Internal Medicine Resident Yale University Chapter Leader
The Primary Care Project
Notes from the Road
Another messaging tool helping PCP become one of the leading voices of primary care change is what we call “The Road Show.” PCP’s President, Dr. Andrew Morris-Singer, has been spreading the word about primary care reform, spending much of the year on the road visiting primary care training institutions and clinics across the country. This year, he delivered his presentation, “All Hands on Deck,” about the importance of teams in revitalizing primary care, 17 times to a multitude of audiences. His talks have inspired collaborations, forged new relationships and created new chapters.
Revitalizing primary care in the United States and reinvigorating the primary care workforce pipeline is a massive undertaking. It will require the mobilization of a tremendous team effort to overcome numerous obstacles. The primary care community’s greatest impediment to solving the primary care crisis is not a lack of innovation. Rather, it is a collective inability to scale up solutions that are known to work. That is why we launched the Primary Care Project in the fall of 2013. “The Project” creates a space where groups working in primary care revitalization can come together to showcase best practices, share resources and raise awareness among the general public about the importance of primary care and the need to revitalize the pipeline. The Primary Care Project will engage the public on the issues around our fractured primary care system. It will also provide a concrete “home” for the many groups committed to the movement to revitalize primary care. We believe “the Project” will provide a strategic roadmap for the growing ranks of students, faculty, providers and advocates who are inspired every day to change primary care. This coalition of primary care advocates will continue to unite under a common front because joining the forces of our collective efforts is the only way we will bring about the systemic change our health care system so desperately needs.
“I am thrilled to lend my voice to the future of primary care. Primary care needs a change, and the students in the health care field are going to bring that dynamic change.” Karly Pippitt, MD Family Physician and PCP Chapter Faculty Advisor University of Utah
Looking Forward
Above: PCP President Dr. Andrew Morris-Singer speaks at the second annual Gregg Stracks Leadership Summit.
The American health care system is at a crossroads. Without the establishment of a robust foundation of primary care, the fruits of health care reform will likely go unrealized. At Primary Care Progress, we are committed to continuing to leverage our unique, community-building strategy to help make that revitalized primary care system a reality. Our success will depend upon our ability to seize the moment and promote critical changes to health care education and training. In 2014, we will focus on strengthening our leadership training program, promoting innovations to improve patient care, and leading the national dialogue on revitalizing primary care. Our time is now and we will need your support in these efforts. Americans deserve no less.
Annual Report 2013
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Financial Information For the year ending December 31
Revenue
2013
2012
2011
Contributions and Grants
889,064
997,548
796,600
Other Income
47
19
17
Net Assets released from restrictions
0
-20,000
0
$997,567
$796,617
Total Revenue $889,111 Operating Expenses Program Services
721,322
723,358
530,926
Administration
92,463
77,583
130,992
Development
36,992
37,955
30,261
$838,896
$692,179
Total Operating Expenses $850,777 Change in Net Assets from Operations
38,334
158,671
104,438
Net Assets, beginning of year
421,414
262,743
158,305
$421,414
$262,743
Net Assets, end of year $459,748
Fundraising 4%
Administration 11% In 2013, 85 percent of total expenditures went to program expenditures, 11 percent to administration and 4 percent to fundraising.
Program Services 85%
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Primary Care Progress
Leadership
Funders & Donors
Board of Directors
Leadership Circle The Kassel-Backer Family Foundation The Gordon and Jenny Singer Foundation Seth and Beth Klarman National Philanthropic Trust Morris-Singer Foundation Josiah Macy Jr. Foundation Cliff and Laurel Asness Bill Helman Anonymous
Andrew Ellner, MD Co-Director, Center for Primary Care Harvard Medical School
Andrew Morris-Singer, MD President and Founder Primary Care Progress
Corey Morris-Singer, PhD Treasurer and Co-Founder Primary Care Progress
Kavita Patel, MD, MS Managing Director, Engelberg Center for Health Care Reform Brookings Institution
Lesley Solomon, MBA Director of Strategy and Innovation, Biomedical Research Institute Brigham and Women’s Hospital
National Advisory Board Richard Baron, MD Tom Bodenheimer, MD, MPH Marjorie Bowman, MD, MPA Jeffrey Brenner, MD Campbell Brown Tina L. Cheng, MD, MPH Susan Edgman-Levitan, PA-C Joseph P. Frolkis, MD, PhD Kevin Grumbach, MD Paul Grundy, MD, MPH Kevin Krim Cindy Lord, MHS, PA-C Jim McDermott, MD Arnold Milstein, MD, MPH Christine Sinsky, MD Virginia Tilden, PhD, RN Elizabeth Whittemore, MSW, MPH
Donors Amanda Hoffman Andrew Ellner and Christine Pace Anthony Miller Carol Peacock Christine Liu David Bates Donald Glazer Evan Wolfson Frank Baxter Frank Morris Harvard Medical School Center for Primary Care Jerrold Ellner Jim Sabin Kathy Le and Michael Warres Kristen Goodell Larry Singer Lesley Solomon Lewis Levy Linda Singer Lisa Drapkin and Debbie Lewis Marc Solomon Martha Stanton and Roger R. Bradford Mary Sweeney Maureen Mavrinac Melissa Gillooly and Christian Allen Philip and Barbara Cusumano Randi Sokol Richard and Lisa Perry Richard Bottner Sean Burke Teresa Morris Tye Lidman University of Utah Institute for Healthcare Transformation Virginia Tilden
Annual Report 2013
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www.primarycareprogress.org
1035 Cambridge Street, Suite 28A | Cambridge, MA 02141 | 617-714-4260