Posted on behalf of Larry Green, MD
It is improbable that the structure and content of family medicine residency programs as designed in the late 1960’s would prove sufficient more than 40 years later to produce the family physicians needed across the country. A period of experimentation has commenced, ignited by the Association of Family Medicine Residency Program Directors and the American Board of Family Medicine with a program called “Preparing the Personal Physician for Practice” (P4).
P4 aspired to stimulate widespread innovations in family medicine residency training, and Colorado was quick to step up and out to organize the FM residency programs into an innovative learning collaborative, headed up by Perry Dickinson in partnership with HealthTeamworks. This program is learning a ton about how important leadership, clear decision-making, quality improvement, and teamwork are in Colorado’s residencies, and the focus on the PCMH has proven to be productive. North Carolina has built from some of their prior work to organize something similar, placing them and Colorado at the leading edge of the very hard work of transforming training sites and curricula. This journey is going to take awhile and it is hard work.
A lot of organizations and national leaders know about what is going on in Colorado and point to it to make the case that even in the difficult, if not toxic, environment in which this redesign work is occurring, change and progress is possible and “spreadable.” What is going on here is important, and it going to spread to other states. Not unlike the beginning of FM in the 1960s when Ward Darley and Wes Eisle built from the University of Colorado General Practice Residency program to help design the current FM residencies, Colorado is doing more than its fair share to get the next redesign show on the road.
Hats off to the residencies, Perry and his teammates, HealthTeamworks, and The Colorado Health Foundation! This enterprise matters now and will matter more, favorably affecting a lot of residents and a lot of patients for years to come.