Comprehensive Primary Care Team Model: Early Insights on Implementation from Care Teams in Family Medicine.

Abstract

Family medicine faces critical challenges including workforce shortages, limited patient access, and the need for sustainable care models. We implemented a Comprehensive Primary Care Team (CPCT) model pairing physicians with three to four advanced practice clinicians (APCs) in four community-based clinics serving rural Central Texas. This special communication provides insights into early implementation of this model (about 12 months post-implementation). We conducted informal qualitative interviews to understand clinician perspectives on early implementation. This included site visits with the four clinics piloting the CPCT model (n = 19). Interviewees included physicians and APCs. Interviews focused on daily workflows, scheduling, interprofessional communication, patient access, panel-size management, collaborative practices, and perceived barriers. We also conducted an analysis of third next available appointment using administrative data to get a snapshot of our goal to increase access. This analysis compares one CPCT model clinic with a solo-practice clinic. Insights from these informal interviews centered on 4 themes: (1) Teamwork and Collaboration, (2) Access and Scheduling, (3) Panel-Size Management, (4) Clinician Satisfaction. The third next available appointment analysis revealed substantially more appointment availability in the CPCT model clinic across multiple visit types. The CPCT model has potential to be a scalable innovation enabling family medicine practices to safely expand panel sizes, improve access to care, and operationalize physician-led population health management. Ongoing challenges include right-sizing teams, space limitations, and workflow optimization, but early insights support replication in primary care settings seeking to address access gaps and workforce constraints while maintaining quality of care.