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Hope Springs Eternal in Primary Care, Says Peter Meyers

PeterMyersWhile focusing on primary care this month (because of our 2014 Primary Care Challenge live event on September 16) we came across Peter Meyers, a fourth-year medical student from the University of Minnesota. Peter is the Clinical Innovation Content Fellow at Primary Care Progress, and he just finished a MPH program focused on health policy. As we worked with Peter, we found that he has deep insight into the role of primary care physicians in creating, analyzing and promoting patient-centered health policies.

We chatted with Peter about his work at PCP and the importance of primary care.

First, tell us about Primary Care Progress’s Clinical Innovation Network (CIN). What do you do as the CIN content fellow? 

CIN has two divisions: content and community. As the content fellow, my main responsibility is organizing and moderating online webinars aimed at medical students and residents. Our goal is to bring our audience to the cutting edge of innovation. The CIN community fellows work with local Primary Care Progress chapters to determine their understanding of clinical innovation, their areas of interest, and opportunities for improvement.

The big idea here is that we believe in connecting students to national and global ideas, helping them understand the context and relevance of their own local work. If we can connect students to interesting things happening at the national or global level, show them how it relates to their own communities, and give them to the tools to make an impact, a few of them might be motivated to become leaders in the field. That’s what we’re trying to do: motivate and train the next generation of leaders in primary care.

Sounds like you spend a lot of time thinking about clinical innovation. Can you tell us about the most notable innovations you’ve seen? What kinds of changes should we expect to see in the future?

Tough question! It’s hard to pick favorites. I’m terrible at it. I think you’ll see us highlight a wide variety of innovations this year, from clinical workflow redesigns (e.g. complex care coordination clinics for high utilizing patients) to mobile or online systems that improve care delivery and inter-professional integration. You’ll have to tune into the CIN this year to hear more details.

You’re working for Primary Care Progress, so we know that you focus on primary care almost every day. Why is primary care so important within the American healthcare system?

First of all, I want to point out that we don’t actually have a real healthcare “system” in our country. We have a unique patchwork of delivery systems that interact with each other, some better than others. More specifically, we have a private health insurance system, a public health insurance system (Medicare, Medicaid), single-payer systems (Veterans Affairs, Indian Health Services), and now a series of insurance marketplaces that offer a combo of several types of plans. The reason I bring this up is because patients rarely stay in one of these delivery systems their entire life (and often switch many times throughout their life). This ever-shifting landscape requires extensive communication and coordination among healthcare professionals to properly manage a patient’s health. And who’s doing a majority of that communication and coordination? Primary care providers! (And I mean MDs, PharmDs, NPs, PAs, RNs, etc.)

So primary care is the bedrock of this healthcare “system.” It’s the super glue that’s holding our rickety boat together. Several international studies have found a correlation between the degree of investment in primary care with improved outcomes and lower costs, and that’s amazing. Right now, millions of Americans don’t have adequate access to a primary care physician. The Affordable Care Act offers positive changes in primary care funding, improving access to providers, and incentives for innovation (particularly in efficiency of care delivery), but it also leaves much of our healthcare “system” in place. So, at least in the short term, it appears that we’re stuck with our patchwork system. In order to optimize the experience of our patients within this broken system, strengthening primary care must be a top priority.

You’re studying to be a primary care physician yourself, right? Has it been what you expected?

I chose to enter healthcare because I’ve always loved anthropology and biology. I honestly wasn’t concerned about the chaos of the field (although I was warned several times and informed that I “shouldn’t go into primary care” by several physicians I met in college.) Honestly, I like hearing people’s stories and that’s a critical part of primary care. Listening to a story and connecting with that person is, in my opinion, a crucial and under-appreciated component of being a good physician. Certainly you must learn the physiology and have an understanding of the current literature, but that information won’t get you anywhere if your patient doesn’t trust you enough to be honest about their symptoms.

And as for the chaos of our current system, it’s exciting. This is an incredible time to be going into primary care. We are in the early stages of a data-driven healthcare revolution that could change everything about the way medicine is practiced. My generation of physicians will be leaders as we come out on the other side of these changes and that’s a rare opportunity. We at the CIN are trying to find the most exciting parts of this revolution and bring them to the fingertips of students and residents.

You have so much enthusiasm for this career path and for healthcare in general. Do you see “innovation” – especially the innovations that you cover in your webinars – as making a big difference?

I think innovation, as an abstract idea and a learned skill, offers several important functions. As I mentioned before, our “system” is kind of a mess. So innovation is a powerful tool for improving care, increasing access, and lowering costs. There will always be motion in the healthcare system and innovation prevents regression.

As an abstract idea, innovation is the hope that springs eternal. There have been countless articles about how current primary care providers (particularly physicians) are dissatisfied with their careers. These articles note that the physicians have become exactly the type of physician they never thought they’d be: disengaged, disinterested, callous, and paternalistic. And, almost universally, they blame a system that emphasizes short visits and long hours, leading to burnout. For those providers, innovation offers the chance to leave their current situation behind and rediscover their passion for patient care.

One thing I want to say is that clinical innovation, specifically, is often perceived as less “sexy” than other types of innovation. Important advancements in robotic surgical procedures, pharmacotherapies, and new forms of radiotherapy get more recognition. But clinical innovations may actually influence more lives on a regular basis than many of the “sexy” innovations that make headlines. I think my job at CIN is to help bring a few clinical innovations to the forefront and give them the attention they deserve.

Jenni Whalen

Jenni Whalen

    Jenni Whalen is the Executive Assistant of Editorial at Upworthy. She was previously MedTech Boston's Managing Editor and has an MS in Journalism from Boston University, as well as a BA in Psychology from Bucknell University. Whalen has written for Greatist, Boston magazine, AZ Central Healthy Living and the New England Journal of Medicine, among other places. She has also worked as a conference planner, ghost writer, researcher and content developer.

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