What does society need from the personal physician of the future?
4Cs of Primary Care Outcomes (plus a proposed 5th C)
There is substantial evidence that the four Cs-first contact care, continuity, comprehensiveness, coordination of care are core functions of primary care and are critical for improving the health of populations and addressing the quadruple aim. Training the 4Cs must thus be at the core of family medicine training.
How should they be adapted for the 2020’s and beyond?
What does first contact care and access to care mean in an age of increasing 24 x 7 video encounters with strangers?
How should telehealth and urgent care fit into continuity?
What should our approach be in training for comprehensiveness when multimorbidity and complex care drive most morbidity and cost and obstetrical deserts are rapidly expanding?
What does care coordination mean when care managers without personal relationships with patients are increasingly common?
In addition to the “4 Cs”, we believe that we need to include a 5th C—community engagement, to address unmet social needs in our communities. Community has been a part of the family medicine movement since the 1960’s Millis and Folsom reports.
How do we train personal physicians to work in and with communities to address disparities and the social drivers of health and to facilitate the lifestyle changes necessary to prevent and manage chronic disease?