Baylor Family Medicine Residency - Community Health Center at Northwest
Baylor College of Medicine-Harris Health System Family Medicine residency program is one of the 14 programs to participate in the P4 (Preparing the Personal Physician for Practice) project. Initiated by the Future of Family Medicine, the national leadership of the specialty of Family Medicine, we have embarked on bold innovations in training that will ideally prepare residents to practice in the future. We are committed towards development of a university program renowned for outstanding training in Family Medicine.
Situated in the fourth largest city in the United States and associated with one of the largest public health systems, Northwest Community Health Center physicians are strongly committed to introducing new model practice components. The center took the lead in implementation of an Electronic Health Record, EPIC, April 2006, linking hospitals and community centers. The center continues to introduce practice redesign elements such as group visits, enhanced patient access, and clinical staff inclusion through Patient Care Teams. Residents participate in these project planning teams and witness first-hand the impact on their practices. Because of the high prevalence of chronic medical problems in our population, a transformation of the center’s chronic disease management approach is our next major focus.
To produce graduates equipped to provide population-based high quality humanistic care to patients in underserved settings, and lead the delivery of such care.
We have modified the traditional Family Medicine curriculum to concentrate on three developmental stages in the creation of our ideal personal physician:
- Develop a strong Family Medicine identity
- Solidify proficiency in Ambulatory Clinical Care
- Prepare for future leadership roles
Our training begins with an emphasis at the Family Medicine Center, then complemented by longitudinal ambulatory specialty experiences. Subsequent years provide concentrated experiences in hospital-based care. Throughout training, residents maintain FMC continuity at least 40 percent of the time.
Our rationale for this sequencing is to allow first-year residents the opportunity to gain confidence through mentoring relationships developed as members of practice-learning teams.
With a focus on prevention and managing chronic conditions, Practice-Learning Teams have been established consisting of a continuity preceptor, residents at each level, and clinical staff including health educators and behavioral health. These Practice-Learning Teams meet weekly and provide two essential functions related to core Family Medicine Identity:
- Facilitate residents' development of unique personal characteristics of a family physician that are essential to improving patient care
- Initiate programs to improve health outcomes in the Family Medicine Center.
Practice-Learning Teams build upon the Family Medicine Identity. The process hones residents' skills though structured reflection on emotional intelligence, exposure to leadership styles and roles, involvement in group dynamics, improved communication, and conflict resolution. This is in part achieved by utilization of validated web-based instruments for self-reflection, as well as interactive exercises for developing and understanding group cohesiveness. These activities are an extension of an existing Leadership curriculum, with activities selected to meet the evolving needs of the Practice-Learning Teams.
Practice-Learning Teams deploy innovative practice elements from the New Model Core Components and Principles to guide development of programs. Programs are geared to care for patients identified through chronic illness registries as “poorly controlled” and most likely to benefit from having a personal physician supported by a multidisciplinary team. Through this chronic disease management program tailored for the underserved setting, these complex patients’ care entail group visits, practice guideline/ decision support software, and systematic emphasis on improving outcomes of care. In addition, Practice-Learning Teams construct preventive care programs to ensure that their assigned patient panel members receive appropriate health maintenance and disease screening services.
Preparing the Personal Physician for Practice (P4) expanses the entire three years in our program. Through our institutional relationships, we have developed opportunities for our residents to be at the forefront of medical care. Throughout their experience here, our residents are encouraged to participate in institutional health fairs, administrative meetings and be involved in health care committees. We encourage our residents to be active participants in medical and teaching associations, at the local, state, and national levels.