Strides in Primary Care

New professorship and other efforts bolster an under-recognized specialty.

Published in Summer 2015 and Dome - May 2015

When Americans talk about physicians, many speak enthusiastically about their family doctors, pediatricians or general internists. Among medical students, however, primary care remains less favored as a career choice than other specialties. Lower pay, longer hours, low Medicare reimbursements and more elderly, complex patients contribute to its unpopularity across the nation. By 2025, experts predict a potential shortfall of up to 31,100 primary care physicians.

Now, with the creation of a Bloomberg Distinguished Professorship devoted to primary care—a position that includes teaching nursing and public health students—Johns Hopkins Medicine hopes to invigorate and advance the field, says Maura McGuire, assistant dean for part-time faculty. This year, the school of medicine will also launch a primary care track for interested medical students, with a focus on chronic disease treatment, research and health care delivery.

The professorship was announced at the recent Johns Hopkins Primary Care Consortium, a biennial event intended to “share the energy around creating a collaborative, multidisciplinary academic home for primary care at Hopkins,” says McGuire, who also serves as Johns Hopkins Community Physicians’ director of education.

Held in February, the daylong conference drew more than 200 health care professionals, Johns Hopkins leaders and trainees from across the institution to Turner Auditorium. Speakers addressed evidence-based clinical processes, leadership, education and public policy development on primary care.

The idea for the new professorship grew out of the first Johns Hopkins Primary Care Consortium, established in 2013 by a core group of seven colleagues from the schools of nursing, medicine and public health who felt the need to be more aggressive in advancing primary care. Leading the nationwide search are John Flynn, vice president of the Office of Johns Hopkins Physicians, and David Chin, distinguished scholar at the school of public health. The goal is to fill the position in 2015.

“People around Johns Hopkins are becoming more attuned to the importance of primary care,” says McGuire. “They’re realizing that primary care is part of the solution to improving quality, outcomes and cost.”

Topics at the biennial focused on how to inspire excellence, innovation and joy in primary care settings, and how to drive more health professionals into careers in primary care.

In an impassioned first-person account, second-year medical student Juliana Macri described how her mother’s “old-school” general internist painstakingly unraveled a misdiagnosis of Lyme disease made in an emergency room. She credits him for preventing her mother’s situation from becoming more serious—he recognized that she had babesiosis, another tick-borne illness—and for inspiring Macri to pursue a career in primary care.

Challenging “the myth that primary care isn’t what Hopkins does,” Macri urged her audience to insist that primary care be as significant a part of a Johns Hopkins medical education as understanding organ transplantation and Whipple procedures for pancreatic cancer.

When it debuts this summer, the school of medicine’s primary care track will include a three-year clinical experience in innovative practices, research projects, a clinical rotation for fourth-year med students, and mentorship and interaction with local leaders in the primary care field.  Colleen Christmas, Johns Hopkins Bayview Medical Center’s internal medicine residency director, oversees the new track and hopes that the students who complete it will enter primary care-oriented residencies.

The new Bloomberg Distinguished Professor will guide these and other efforts, notes McGuire, “and become an accelerator to connect with others doing primary care research.” That person will also boost philanthropy and advance coordination and integration of primary care in the medical, public health and nursing disciplines across The Johns Hopkins University.

Just as the Armstrong Institute for Patient Safety and Quality has raised the profile of patient safety, notes McGuire, “we plan to create a center of excellence in primary care to improve health outcomes across the life course.”