title: "A Paradox Persists When the Paradigm Is Wrong": Pisacano Scholars' Reflections from the Inaugural Starfield Summit.
abstract: The inaugural Starfield Summit was hosted in April 2016 by the Robert Graham Center for Policy Studies in Family Medicine and Primary Care with additional partners and sponsors, including the Pisacano Leadership Foundation (PLF). The Summit addressed critical topics in primary care and health care delivery, including payment, measurement, and team-based care. Invited participants included an interdisciplinary group of pediatricians, family physicians, internists, behaviorists, trainees, researchers, and advocates. Among the family physicians invited were both current and past PLF (Pisacano) scholars. After the Summit, a small group of current and past Pisacano scholars formed a writing group to reflect on and summarize key lessons and conclusions from the Summit. A Summit participant's statement, "a paradox persists when the paradigm is wrong," became a repeated theme regarding the paradox of primary care within the context of the health care system in the United States. The Summit energized participants to renew their commitment to Dr. Starfield's 4 C's of Primary Care (first contact access, continuity, comprehensiveness, and care coordination) and to the Quadruple Aim (quality, value, and patient and physician satisfaction) and to continue to explore how primary care can best shape the future of the nation's health care system.
authors.affiliation: From the Department of Family and Community Medicine, University of California-Davis (ND) (past Pisacano scholar); Santa Rosa Family Medicine Residency, Santa Rosa, California (AJC) (current Pisacano scholar); Department of Family Medicine and Community Health, University of Wisconsin-Madison (JL) (past Pisacano scholar); Brown Family Medicine Residency, Providence, Rhode Island (DW) (current Pisacano scholar); Department of Family Medicine, Oregon Health & Science University, Portland (JD) (past Pisacano scholar).
authors.forename: Noemi
authors.initials: N
authors.lastname: Doohan
authors.affiliation: From the Department of Family and Community Medicine, University of California-Davis (ND) (past Pisacano scholar); Santa Rosa Family Medicine Residency, Santa Rosa, California (AJC) (current Pisacano scholar); Department of Family Medicine and Community Health, University of Wisconsin-Madison (JL) (past Pisacano scholar); Brown Family Medicine Residency, Providence, Rhode Island (DW) (current Pisacano scholar); Department of Family Medicine, Oregon Health & Science University, Portland (JD) (past Pisacano scholar).
authors.forename: Anastasia J
authors.initials: AJ
authors.lastname: Coutinho
authors.affiliation: From the Department of Family and Community Medicine, University of California-Davis (ND) (past Pisacano scholar); Santa Rosa Family Medicine Residency, Santa Rosa, California (AJC) (current Pisacano scholar); Department of Family Medicine and Community Health, University of Wisconsin-Madison (JL) (past Pisacano scholar); Brown Family Medicine Residency, Providence, Rhode Island (DW) (current Pisacano scholar); Department of Family Medicine, Oregon Health & Science University, Portland (JD) (past Pisacano scholar).
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lochner
authors.affiliation: From the Department of Family and Community Medicine, University of California-Davis (ND) (past Pisacano scholar); Santa Rosa Family Medicine Residency, Santa Rosa, California (AJC) (current Pisacano scholar); Department of Family Medicine and Community Health, University of Wisconsin-Madison (JL) (past Pisacano scholar); Brown Family Medicine Residency, Providence, Rhode Island (DW) (current Pisacano scholar); Department of Family Medicine, Oregon Health & Science University, Portland (JD) (past Pisacano scholar).
authors.forename: Diana
authors.initials: D
authors.lastname: Wohler
authors.affiliation: From the Department of Family and Community Medicine, University of California-Davis (ND) (past Pisacano scholar); Santa Rosa Family Medicine Residency, Santa Rosa, California (AJC) (current Pisacano scholar); Department of Family Medicine and Community Health, University of Wisconsin-Madison (JL) (past Pisacano scholar); Brown Family Medicine Residency, Providence, Rhode Island (DW) (current Pisacano scholar); Department of Family Medicine, Oregon Health & Science University, Portland (JD) (past Pisacano scholar).
authors.forename: Jennifer
authors.initials: J
authors.lastname: DeVoe
mesh_terms: D003266:Continuity of Patient Care / Q000191:economics* / Q000458:organization & administration; D003695:Delivery of Health Care / Q000191:economics* / Q000458:organization & administration / Q000639:trends; D005194:Family Practice / Q000191:economics* / Q000458:organization & administration / Q000639:trends; D018588:Fee-for-Service Plans; D005257:Fellowships and Scholarships; D005582:Foundations; D017048:Health Care Costs / Q000639:trends; D006801:Humans; D007857:Leadership; D017060:Patient Satisfaction; D011320:Primary Health Care / Q000191:economics* / Q000458:organization & administration / Q000639:trends; D058996:Quality Improvement; D014481:United States
keywords: Family; Family Practice; Forecasting; Leadership; Personal Satisfaction; Physicians; Primary Health Care; Research Personnel; Writing