A Team-Based Approach to Primary Care

Since the passage of the Affordable Care Act, primary care has been receiving a lot more scrutiny. In many cases across the nation, the health care system hasn’t been providing the most effective or efficient care.  “We’ve had to do a bit of soul-searching in primary care because we weren’t delivering the goods very well,” said Kevin Grumbach, MD, chair of UCSF’s Department of Family and Community Medicine.

“It was hard to get appointments, and we weren’t meeting all the patients’ needs, especially if you look at diabetes care and rates of preventative cancer screening,” he said. “It’s not enough to just say we need to try harder; we need to rethink the system. So that’s behind this push to rethink what the roles of people are on the provider team.”

Increasingly, studies suggest that a more team-based approach to care could be a big part of the solution. UC San Francisco research has been key in showing the effectiveness and cost-efficiency of the “patient-centered medical home,” and indriving implementation of this model in multiple centers at San Francisco General Hospital.

Instead of the primary care physician trying to do everything in a 20-minute appointment, a whole team of health care providers is responsible for the patient’s care – from nurses to doctors to community health workers to mental health specialists to pharmacists. The team works together to anticipate the patient’s needs, communicate their findings with each other, and make sure no aspect of the patient’s health slips through the cracks.