Academia, Chronic Care, and the Future of Primary Care

The Chronic Care Model provides a framework for redesigning primary care teaching clinics and could give residents positive experiences related to caring for chronically ill patients.

Effective primary care can reduce health costs and consequences of chronic illness. Yet, just at a time when health care needs more primary care physicians, fewer trainees are choosing careers in primary care. When residents were asked their reasons for not choosing primary care, most said that they did not feel confident that they could successfully deliver high quality care to complex, chronically ill patients. And they did not want to go into a career where they felt they might fail.

The Chronic Care Model was developed to help health care organizations improve the care of chronically ill patients through changes to the organization and delivery of care. It also provides a framework to redesign primary care teaching clinics so that they can routinely provide high quality, well-organized chronic care. With better organizational support, residents may be more attracted to primary care as a career choice.

Implementing the Chronic Care Model requires cultural change for most practices. While medical schools have talented faculty, residents and staff to take on such a task, many lack resources and support. Deans, department chairs and administrators need “to create ambulatory training experiences that deliver high quality, efficient care and that excite trainees ultimately to pursue careers in primary care,” the author writes.