New model innovation through faculty champions.

The Future of Family Medicine project calls for transformation of medical practices to a " New Model " to meet challenges facing the discipline of family medicine. 1 While certain components of the New Model have been developed and tested by innovators, 2-4 the barriers of cost, cultural issues, technology problems, and lack of well-defined reimbursement mechanisms have slowed the diffusion of the New Model into both the practice and residency settings. 5-8 Additionally, physicians and clinic leadership are products of prior training models and traditional areas of expertise. 9 For their practices to move into the future, faculty leaders must become champions of New Model concepts, and they are key to the success of this transformation. Should residency programs wait until demonstration projects are concluded on the New Model of practice, or should they move ahead with New Model learning and implementation? As consultants for the American Academy of Family Physicians (AAFP) Residency Assistance Program (RAP), we believe residency programs should be " early adopters. " 11 At a minimum , residency programs should begin preparing for New Model implementation by studying and discussing the model, examining demonstration projects and innovations that address new model components, and analyzing their own systems. Such preparation, particularly if it involves piloting of components, will stimulate organizational learning and will begin to address the many barriers associated with implementation. 12 In seeking resources to help residency programs begin to prepare for New Model implementation, the most valuable resources are a pro-gram's own faculty. Faculty members are core resources, not only for teaching and patient care but for clinic performance, residency curriculum development, role model-ing for residents, and program leadership. Programs that develop their faculty will be best situated to meet the challenges and opportunities of the future. Individual faculty could lead development for some aspect of the New Model consistent with their strengths, taking the residency program through an organizational change process beginning with an assessment of their existing systems of care. Group energy among faculty will initiate and enhance readiness for change and eventual evolution toward the New Model. Larger organizational change techniques such as the " burning platform " (crises that are engineered to force change), use of competing multidisciplinary teams, or formal continuous quality improvement processes are unlikely to work. 13 Creating a burning platform may demoralize faculty and serve as a disincentive to them considering New Model change. Competing …