When John and Carol Moriarty learned about an expected shortage of vitally needed primary care physicians (PCPs), they acted decisively. Recently, they donated $1.5 million to the Crimson Care Collaborative, an innovative program that encourages Harvard Medical School (HMS) students to specialize in primary care.
Created by clinicians at Massachusetts General Hospital and HMS students, the collaborative exposes medical students early on to primary care in six different health clinics in the Boston area.
Primary Care’s Crucial Role
A general contractor from Winchester, Mass., Mr. Moriarty’s buildings grace skylines well beyond Boston. He and his wife Carol, a retired teacher, credit Susan Edgman-Levitan, PA, a friend and Crimson Care’s founder, with helping them become aware of the increasing importance of primary care providers. Executive director of the John D. Stoeckle Center for Primary Care Innovation at Mass General, Ms. Edgman-Levitan is also an expert on patient-centered care. The Moriartys’ gift is in honor of their long-time friend, Lawrence F. Borges, MD, director of Mass General’s Neurosurgical Spine Center and advocate for the collaborative’s goals.
“Primary care physicians are an absolute necessity for the country,” Mr. Moriarty says. “You want someone who has a complete understanding of you and has your records available on a database and who can provide more of a continuum of care.” Both the Moriartys receive their primary care from Mass General clinicians.
By 2025, a significant shortage of primary care physicians is expected, stressing a system already strained by an aging population and chronic illness.
The importance of PCPs in health care cannot be overstated. They deliver and coordinate care while helping to control healthcare costs. They also provide preventive care, often heading off costly, catastrophic illnesses. Patients who see a PCP are less likely to make expensive emergency room visits for routine matters. And with PCPs managing all of a patient’s care, the risks and costs of unnecessary treatment lessen.
But by 2025, a significant PCP shortage is expected, stressing a system already strained by an aging population and people with chronic and complex conditions. Indeed, the deficit could be as much as 31,100 practitioners, estimates the Association of American Medical Colleges.
An Incubator for Primary Care Physicians
Anticipating the shortage, clinicians at Mass General’s Stoeckle Center and HMS students founded the collaborative in 2009. Guided by experienced clinicians, the students run evening clinics in the Boston area. Patients are broadly diverse. Problems vary: short-term and chronic illnesses, mental health disorders, women’s health concerns, socioeconomic issues and more.
The students work in teams, the experienced with the novice. They take a patient’s history, determine the reason for the visit and examine the patient. Next, they present the case to an attending physician, who re-examines the patient.
The clinics also mix in students from area institutions in other disciplines: nursing, physician assistant, dentistry, optometry and social services. “It’s what primary care should be about,” says Ms. Edgman-Levitan. “It focuses on coordinating care.”
“We also have used the clinics as an innovation lab of sorts, to try out new technology, new screening tools,” says Marya J. Cohen, MD, MPH, Crimson Care’s medical director. Two examples are a multilingual text messaging program for appointment reminders and a questionnaire for depression. Students also engage in research.
Overall, Crimson Care has served more than 1,000 students, and more than 2,000 patients. At HMS, it’s now the most popular extracurricular activity. Though preliminary data on the program’s impact is encouraging, a more definitive study is now underway, Dr. Cohen says.
A Chance to Heal, Learn and Bond
“I wanted a healing opportunity,” says Anjali Thakkar, now in her fourth year in Harvard’s combined MD/MBA program and student co-director of Crimson Care. “In fact, I didn’t even understand what ‘primary care’ meant.”
Her first-year encounter with a patient struggling with diabetes was illuminating. When the patient reported eating a donut for breakfast, Ms. Thakkar asked why. The patient said, “Well, that’s what I can afford.” With the help of a social services student, Ms. Thakkar was able to connect the patient to resources for better food. “We can’t give care in isolation of their socioeconomic needs,” she says.
The clinic tries to match medical students consistently with the same patient. “What is really satisfying is having a longitudinal relationship for many years,” Dr. Cohen explains.
For many students, the promise of such a bond may be the tipping factor. Now in rotations, Ms. Thakkar hasn’t picked a specialty. She is applying for residency in internal medicine and will consider other paths after that, including primary care. “That relationship is something that draws me,” she says.
And that’s the kind of response that the Moriartys expect Crimson Care to inspire. “It makes young physicians think about what their role is,” Mr. Moriarty says.
For more information about the Crimson Care Collaborative or to make a donation, contact us.