The patient-centered medical home (PCMH) was a prominently featured topic throughout the recent 43rd annual spring conference of the Society of Teachers of Family Medicine (STFM), beginning with its theme, "LEAD the Way: Leadership, Education, and Advocacy Development to Create a Patient-centered Medical Home (PCMH)." The theme was reflected in the plenary presentations and educational offerings, especially those that focused on the enactment of the Patient Protection and Affordable Care Act. Attending the conference — held April 24-28 in Vancouver, British Columbia — provided a vantage point to hear from colleagues about the opportunities and challenges of the PCMH as well as to meet with STFM leaders on topics and issues of interest to STFM and PAEA.

The impression was universal that the coming changes in the financing and structure of health care in America will benefit not only patients but also those who practice primary care. A key challenge is attracting and training enough primary care providers from the right blend of disciplines to populate PCMHs. Interprofessional training of medical students and residents with students from throughout the spectrum of health professions was frequently addressed in the sessions and also during the plenary speeches.

In my presentation to the STFM Board of Directors, I provided an update about the recent PAEA membership votes on the PA clinical doctorate and medical school bridge programs. I also highlighted the decade-long decline in the percentage of physician assistants (PAs) practicing in primary care and the potential implications for a health system undergoing reform. I noted that regardless of current clinical practice, PAs are trained first as generalists, often in the family medicine model. I stressed that the ability for PAs to move between generalist and focused specialties was an unrecognized strength of our profession. I advanced the idea that training PA students with family medicine residents might influence job availability for graduate PA students and help create learning teams that translate into future practice teams as PCMHs develop and grow.

The immediate past president of STFM, Dr. Terry Steyer, and the executive director, Stacy Brungardt, were gracious hosts who agreed there is considerable potential for collaboration on a wide range of advocacy issues, particularly Title VII. Hope Wittenberg, the STFM director of government relations, is looking forward to discussions with the PAEA Government Relations Committee, chaired by David Asprey, and with Athena Abdullah, PAEA’s director of government relations. The enhancements to Title VII funding may offer intriguing opportunities to support innovative strategies to train and practice in an interdisciplinary fashion. There is also potential for demonstration projects that focus on training experiences that feature family medicine residents and PA students.

Dr. William Miller, a member of the evaluation team of the National Demonstration Project for PCMHs, presented a compelling plenary talk on the project’s preliminary outcomes, which will be published soon in the Annals of Family Medicine. He confirmed the findings of the seminal work done by Barbara Starfield that primary care practices function effectively when based on the four pillars of PCMHs:

• First contact care or a point of entry for new problems
• Ongoing care over time
• Comprehensiveness of care
• Coordination of care across a person’s conditions, providers, and settings

Dr. Miller highlighted the need for interdisciplinary teams to achieve improved patient satisfaction and outcomes and spoke forcefully for the role of physicians as facilitators rather than as authoritative leaders and for the integration of PAs as key members of PCMHs. Success of PCMHs, in his view, is also dependent on the integration of delivery systems with payment systems.