Dr. Gina Luciano, the Associate Program Director of Internal Medicine Residency at Baystate Health, won the 2014 Primary Care Challenge on Tuesday night, following several weeks of crowd-sourced voting online. Luciano pitched her innovative plan to rework primary care residency programs, titled “Training Tomorrow’s Primary Care Physician,” to a panel of five judges and an audience of over 50 enthusiastic primary care innovators, physicians and students at Harvard Medical School.
Tuesday night’s pitch-off event was the culmination of a month long challenge meant to bring the most innovative ideas in primary care to light. Following six live pitches, a panel of healthcare providers considered the possibilities for the future of the primary care field, calling for everything from advocacy, to deeper team cultures, to innovation and new leadership.
“It’s about time that primary care is recognized for the cool that we are,” said Marci Nielsen, the pitch-off moderator and CEO of the Patient-Centered Primary Care Collaborative. “We’re here to do something. Action is what I want to see out of this evening.”
Nielsen got her wish. After a month of crowd-sourced voting, six finalists were flown to Boston to share their ideas with a panel of judges. The judges for the event included Jesus Trevino, an HMS Center for Primary Care Abundance Agents of Change medical student; Christina Hseih, an HMS Center for Primary Care Abundance Agents of Change medical student; Arshiya Seth, MD, an HMS Center for Primary Care fellow; Arshya Vahabzadeh, MD, Resident Child and Adolescent Psychiatrist at Massachusetts General Hospital and Harvard Medical School; and Andrew Zimolzak, MD, MMSc, a post-doc research fellow at Boston Children’s Hospital.
Judging was a tough job, as all six panelists outlined well-defined but structurally different proposals for new innovations, programs and platforms. Luciano’s winning presentation centered around dismal statistics: only two percent of medical students reported wanting to be primary care doctors in a recent study, and Luciano said that the resident experience is often incompatible with the real experience of working as a primary care doctor. She outlined Baystate Health’s award-winning primary care resident program, explaining that the program now has something she calls “PC jealousy” – non primary care residents want in. Luciano’s residents spend more time working in ambulatory care and are able to see patients on a consistent basis.
Ajay Kohli, a medical student from Drexel University College of Medicine, pitched his platform for preventing heart failure. Kohli began to work on the platform when his grandfather died from congenital heart failure several years ago, and he hopes to bring physicians and patients together to create a better process of monitoring the disease. Kohli was ultimately awarded the title of “crowd favorite.”
Cole Zanetti, DO, a Leadership Preventative Medicine Resident at Dartmouth, presented his popular idea for using positively deviant patients – those performing above average despite chronic illness – to guide struggling patients with the same diseases. Zanetti’s idea was a hit in the online contest, earning him first place leading into the live pitch-off. “This idea flips patient empowerment on it’s head,” Zanetti said. “And the structure and incentives are already in place.”
Howard Haft, MD, MMM, CPE, FACPE, a consultant on quality metrics and population health at Shah Associates, discussed the idea of using natural language processing – free text rather than EMR data – to collect more accurate healthcare metrics. “Bad data isn’t worth anything,” he said. “But good data is worth the world.”
Rebecca Glassman, MD, an internal medicine doctor at Beth Israel Deaconess Hospital, shared information about another primary care residency program at BIDMC. Her program, called “the long block,” allows primary care residents to spend more time in outpatient settings. They’re also encouraged to work on their teaching abilities, allowing for creativity, flexibility and leadership.
Finally, John Moore wrapped up the pitch-off, sharing a forward-thinking platform called Twine. Twine allows people to become masters of their diseases, Moore explained, helping them to interact with their doctors in a variety of ways. “People have said to me, ‘No one has ever given me the chance to be in charge,'” Moore said. He quit practicing medicine several years ago to work on developing a platform like this and he hopes that Twine will allow for increased communication between physicians and patients.
Primary care is at a critical point, according to the event’s panelists. Dr. Eric Weil, Associate Chief for Clinical Affairs in the General Medicine Unit at Massachusetts General Hospital, moderated the panel, which included Arshya Vahabzadeh, MD; Andrew Morris-Singer, President and Founder of Primary Care Progress; Asaf Bitton, MD, MPH, Core Faculty Lead for Transformation Strategy and Design at the Harvard Medical School Center for Primary Care; Janice John, Chief Primary Care Physician Assistant at Cambridge Health Alliance; and Ali Kahn, MD, MPP, American College of Physicians National Council of Associates and Clinical Innovator at Iora Health.
“We are a lot closer than a lot of people think to primary care being where we want it to be,” said Bitton, encouraging everyone in the audience to jump full-force into primary care. “The work requires you to be courageous. It’s by definition hard. If it were easy, it’d have been done already.”
Bitton also left the audience with a poignant question regarding the future of a specialty that is poised to transform many aspects of the healthcare system: “Are you going to be the playwright, or the critic? You decide.”
A big thanks to our event partners, including: The American College of Physicians, The American Resident Project, the Harvard Medical School Center for Primary Care, Medstro.com, in-Training.org, Costs of Care, the Society of Teachers of Family Medicine, the Patient-Centered Primary Care Collaborative, Primary Care Progress, the Connecticut Institute for Primary Care Innovation, and the Mississippi, Rhode Island, and Maryland Academy of Family Physicians.
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