Chris Ham speaks to Craig Tanio, Chief Medical Officer at ChenMed, about how the US-based primary care-led delivery model offers care to older patients with complex needs.
Craig talks about the innovative features of the model, which include a one-stop shop for patient care with a range of other services like diagnostics and acupuncture provided onsite, a low patient-to-doctor ratio, and close partnership working between clinicians and specialists. He also explains what's changed for patients and staff as a result, and what inspiration clinicians in England could take from the model.
I think the other point is that it breaks the cradle to grave, vertical approach to primary care, and implies that other groups of patients ( children, younger adults) are also being looked after by specialist teams of GPs. That may superficially seem to be a sensible approach, but would lessen the generic skills of GPs in the 24/7 Urgent Care setting who are needed to safely assess a neonate one minute and a 90 year old the next. ChenMed sounds fantastic but I would be cautious about the unintended consequences.
It promises wonderful things to suggest this way of working, and I would love the communication barriers between specialties to be overcome and integrated care to benefit our patients; however, it is unrealistic to imagine the model can be transplanted from the USA to the UK unless there is a massive drive to make general practice a more attractive career option with the attached *long term* funding that is needed.