Primary care is the backbone of an accessible, efficient and high-quality health care system. Without a robust primary care workforce, attempts to address the unequal access and spiraling costs that challenge the current system cannot succeed. Yet fewer aspiring physicians are choosing to focus in primary care, citing long and sometimes unpredictable hours, lower payments and frustrating models of practice.

To begin finding solutions to these challenges and revitalize primary care among practitioners, medical students and residents, a team of researchers funded by the ABIM Foundation visited 23 high-performing practices across the U.S. and presented their findings at a conference entitled Primary Care Innovation: Improving the Efficiency and Appeal of Practice: "How Did They Do That?"

The following video vignettes resulting from the conference offer examples of innovations and critical changes from a variety of practices across the country, and explain how they were implemented to improve the quality of care delivered and restore joy to practice.

Part I - Dr. Chris Sinsky, MD, Medical Associates Clinic and Health Plans, describes the challenges facing primary care, including the decreasing number of medical students focusing in primary care and the dangers of physician burnout.

Part II - Dr. Sinsky highlights practices that have implemented innovations to address challenges of physician burnout and improve care for patients, including moving to a teamwork model and scribing.

Part III - Dr. Sinsky describes additional innovations, including e-mail management and filtering, warm hand offs and the role of improvement specialists.

Part IV - Rachel Willard, MPH, University of California, San Francisco, focuses on how these innovations conceptually fit in with the patient-centered medical home concept and of role of joy in practice.