I Am a Primary Care Champion: Mai Pham

This Q&A is republished here from the Spring 2022 PCC Newsletter, the quarterly enewsletter sent to PCC friends and supporters. Each month in PCC's newsletters, the PCC provides a short profile of an individual who works in primary care. It is a way of recognizing the dedication and passion that clinicians, advocates, and others have for primary care and connecting people in the PCC community to people like them.

Hoangmai Pham

President and CEO, Institute for Exceptional Care

Why are you passionate about primary care?
 
I started my career as a primary care physician in underserved communities – North Philadelphia, Washington Heights in New York City, and East Baltimore. I also have a child with special needs and an elderly parent. So I have a deep appreciation of what primary care at its best can do to improve people’s lives, especially for people with complex life and clinical challenges. Integrating all those considerations into goals and care plans that solve problems is neither art nor a check-list exercise. It demands deep knowledge and intellectual heft, empathy, and the skill to steer people and resources. I still believe it’s the most gratifying clinical path to travel on.
 
If you had a magic wand that you could wave to change one thing in primary care, what would it be?
 
I would offer every primary care clinician better-than-average resources (teammates, tools, income) on a predictable basis so they could stop worrying about administrative and financial survival and just focus on what their patients need.
 
What one thing about your work do you want people working outside primary care to know or understand?
 
I used to think that advocating to transform health care for people with intellectual and developmental disabilities, which is the focus of Institute for Exceptional Care, is somehow distinct from other health policy work. Now I thoroughly understand the universalism of keeping front and center the needs of the most vulnerable populations, because when we design health systems to meet their complex needs – like more flexible communication options, more connectedness to home-and-community-based services, etc. – we’ll have designed health systems that serve everyone better. We will all be disabled at some point in our lives. This is a truth that primary care clinicians intuit. If I diligently use plain language in educating patients, all my patients will benefit. If I allow caregivers into an exam room and leverage their expertise, all my patients will benefit.
 
Looking back on your career, what’s the most significant contribution to primary care that you or your team have made?

I would say first, the research that I did quantifying how fragmented care patterns are in the U.S., showing that the average clinician shares his or her patients with hundreds of other clinicians, which paints a realistic picture of the burden of care coordination that clinicians shoulder. And second, the privilege I had of being the architect of the Centers for Medicare and Medicaid Services’ early value-based payment programs and our deliberate decision to place primary care at the center as the clinical foundation in many of those models. But probably I’m most excited about what I’m working on now, to expand our expectations for primary care to drive the production of community health and the erasure of health disparities.