title: Patient Relationships and the Personal Physician in Tomorrow's Health System: A Perspective from the Keystone IV Conference.
abstract: A group of senior leaders from the early generation of academic family medicine reflect on the meaning of being a personal physician, based on their own clinical experiences and as teachers of residents and students in academic health centers. Recognizing that changes in clinical care and education at national and local systems levels have added extraordinary demands to the role of the personal physician, the senior group offers examples of how the discipline might go forward in changing times. Differently organized care such as the Family Health Team model in Ontario, Canada; value-based payment for populations in large health systems; and federal changes in reimbursement for populations can have positive effects on physician satisfaction. These changes and examples of changes in medical student and residency education also have the potential to positively affect the primary care workforce. The authors conclude that, without substantive educational and health system reform, the ability to truly serve as a personal physician and adhere to the values of continuity, responsibility, and accountability will continue to be threatened.
authors.affiliation: From the Department of Family and Community Medicine, University of Missouri School of Medicine, Columbia (JMC); the Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison (JJF); the Department of Family Medicine and Community Health, University of Minnesota, Minneapolis (MAB); the Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH (JWK); and the Department of Family Medicine, Queen's University, Kingston, Canada (WWR). ColwillJ@health.missouri.edu.
authors.forename: Jack M
authors.initials: JM
authors.lastname: Colwill
authors.affiliation: From the Department of Family and Community Medicine, University of Missouri School of Medicine, Columbia (JMC); the Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison (JJF); the Department of Family Medicine and Community Health, University of Minnesota, Minneapolis (MAB); the Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH (JWK); and the Department of Family Medicine, Queen's University, Kingston, Canada (WWR).
authors.forename: John J
authors.initials: JJ
authors.lastname: Frey
authors.affiliation: From the Department of Family and Community Medicine, University of Missouri School of Medicine, Columbia (JMC); the Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison (JJF); the Department of Family Medicine and Community Health, University of Minnesota, Minneapolis (MAB); the Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH (JWK); and the Department of Family Medicine, Queen's University, Kingston, Canada (WWR).
authors.forename: Macaran A
authors.initials: MA
authors.lastname: Baird
authors.affiliation: From the Department of Family and Community Medicine, University of Missouri School of Medicine, Columbia (JMC); the Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison (JJF); the Department of Family Medicine and Community Health, University of Minnesota, Minneapolis (MAB); the Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH (JWK); and the Department of Family Medicine, Queen's University, Kingston, Canada (WWR).
authors.forename: John W
authors.initials: JW
authors.lastname: Kirk
authors.affiliation: From the Department of Family and Community Medicine, University of Missouri School of Medicine, Columbia (JMC); the Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison (JJF); the Department of Family Medicine and Community Health, University of Minnesota, Minneapolis (MAB); the Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH (JWK); and the Department of Family Medicine, Queen's University, Kingston, Canada (WWR).
authors.forename: Walter W
authors.initials: WW
authors.lastname: Rosser
mesh_terms: D000046:Academic Medical Centers / Q000639:trends; D003695:Delivery of Health Care / Q000379:methods / Q000639:trends*; D005194:Family Practice / Q000193:education / Q000379:methods / Q000639:trends*; D018166:Health Care Reform; D006801:Humans; D007396:Internship and Residency; D007857:Leadership; D058991:Patient Protection and Affordable Care Act; D010549:Personal Satisfaction; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000193:education / Q000523:psychology*; D011320:Primary Health Care / Q000379:methods / Q000639:trends*; D013337:Students, Medical; D014481:United States
keywords: Doctoring; Family Medicine; Family Physician; Health Care Delivery; Personal Physician; Population Health; Primary Care; Professionalism; Social Justice