Primary care residency programs and their associated primary care clinics face challenges in their goal to simultaneously provide a good education for tomorrow’s doctors and excellent care for today’s patients. A team from the Center for Excellence in Primary Care at the University of California, San Francisco, conducted site visits to 23 family medicine, internal medicine, and pediatric residency teaching clinics. The authors found that a number of programs have transformed themselves with respect to engaged leadership, resident scheduling, continuity of care for patients and residents, team-based care, and resident engagement in practice improvement. In this Commentary, the authors highlight the features of transforming programs that are melding inspiring resident education with excellent patient care. The authors propose a model, the 10 + 3 Building Blocks of Primary Care Teaching Clinics, to illustrate the themes that characterize transforming primary care residency programs.
R. Gupta is assistant clinical professor of medicine, Division of General Internal Medicine, and associate medical director, General Medical Clinic, San Francisco General Hospital, University of California, San Francisco, San Francisco, California.
K. Dubé is research associate, Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California.
T. Bodenheimer is professor emeritus, Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California.
Funding/Support: Funding was provided by the Josiah Macy Jr. Foundation.
Other disclosures: None reported.
Ethical approval: Reported as not applicable.
Correspondence should be addressed to Thomas Bodenheimer, Center for Excellence in Primary Care, University of California at San Francisco, Building 80-83, SF General Hospital, 995 Potrero Ave., San Francisco, CA 94110; telephone: (415) 206-6348; e-mail: TBodenheimer@fcm.ucsf.edu.