{"id":37929,"date":"2016-12-06T18:39:10","date_gmt":"2016-12-06T17:39:10","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=37929"},"modified":"2016-12-08T10:28:22","modified_gmt":"2016-12-08T09:28:22","slug":"william-cayley-comprehensiveness-diversity-and-primary-care","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2016\/12\/06\/william-cayley-comprehensiveness-diversity-and-primary-care\/","title":{"rendered":"William Cayley: Comprehensiveness, diversity, and primary care"},"content":{"rendered":"<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2014\/07\/bill_cayley_2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-31912\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2014\/07\/bill_cayley_2-243x300.jpg\" alt=\"bill_cayley_2\" width=\"115\" height=\"141\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2014\/07\/bill_cayley_2-243x300.jpg 243w, https:\/\/blogs.bmj.com\/bmj\/files\/2014\/07\/bill_cayley_2.jpg 551w\" sizes=\"auto, (max-width: 115px) 100vw, 115px\" \/><\/a>As medicine continues to grow in complexity and diversity, it is fair to ponder what roles may be best suited for the medical workforce of the future. A <a href=\"http:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2556009\">recent opinion piece argued that<\/a> since we have no models permitting \u201cany single physician to simultaneously and effectively serve the many patient subpopulations that exist,\u201d we need to recruit, educate, and sustain a \u201cdiverse\u201d health and healthcare workforce.<\/p>\n<p>While I agree wholeheartedly that our workforce of the future needs caregivers who are technically skilled and adept at interdisciplinary collaboration, we also need to balance the increasing degree of specialization and compartmentalization in healthcare with a genuine appreciation for the breadth and generalism of primary care and family medicine.<!--more--><\/p>\n<p>Family physicians are \u201cpersonal doctors for people of all ages and health conditions,\u201d providing \u201cfirst contact\u201d care for acute needs, and directly addressing most of the healthcare needs of their patients. Additionally, family physicians can provide enduring continuity relationships in helping patients \u201c<a href=\"http:\/\/www.stfm.org\/FamilyMedicine\/Vol47Issue8\/Puffer598\">manage illness, navigate the health system, and set health goals<\/a>.\u201d<\/p>\n<p>Furthermore, when one considers <a href=\"http:\/\/www.topalbertadoctors.org\/file\/top--evidence-summary--value-of-continuity.pdf\">the evidence that continuity in primary care is associated with<\/a> improved quality, savings, adherence, preventive care, and reduced mortality, it is clear that the continuity offered by family physicians has the potential to provide better overall healthcare than care that fragments acute, chronic, and end of life care among different specialty teams and locations.<\/p>\n<p>Finally, it has been clearly demonstrated at the systems level that primary care \u201c<a href=\"http:\/\/www.commonwealthfund.org\/usr_doc\/Starfield_Milbank.pdf\">helps prevent illness and death<\/a>\u201d and is associated with \u201cmore equitable distribution of health in populations.\u201d<\/p>\n<p>Family physicians are trained to provide the breadth (across the lifespan) and comprehensiveness (across settings and conditions) of care needed to serve our ever more complex population\u2014encompassed within a continuous relationship that enhances quality over the long term. As we look to educate our future healthcare workforce, we need to ensure that <a href=\"http:\/\/www.stfm.org\/FamilyMedicine\/Vol47Issue8\/Hughes620\">family medicine and primary care physicians<\/a> have\u00a0a central and integral role.<\/p>\n<p><em><strong>William E Cayley Jr<\/strong>\u00a0practices\u00a0at the Augusta Family Medicine Clinic; teaches at the Eau Claire Family Medicine Residency; and is a professor at the University of Wisconsin, Department of Family Medicine.<\/em><\/p>\n<p><strong>Competing interests:<\/strong>\u00a0&#8220;I declare that I have read and understood BMJ policy on declaration of interests and I have no relevant interests to declare.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>As medicine continues to grow in complexity and diversity, it is fair to ponder what roles may be best suited for the medical workforce of the future. A recent opinion [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2016\/12\/06\/william-cayley-comprehensiveness-diversity-and-primary-care\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1357,14769],"tags":[],"class_list":["post-37929","post","type-post","status-publish","format-standard","hentry","category-us-health-care","category-william-cayley"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>William Cayley: Comprehensiveness, diversity, and primary care - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2016\/12\/06\/william-cayley-comprehensiveness-diversity-and-primary-care\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"William Cayley: Comprehensiveness, diversity, and primary care - The BMJ\" \/>\n<meta property=\"og:description\" content=\"As medicine continues to grow in complexity and diversity, it is fair to ponder what roles may be best suited for the medical workforce of the future. 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