On May 20, the Primary Care Collaborative (PCC) and American College of Clinical Pharmacy (ACCP) held a webinar exploring the powerful role coordinated, team-based approaches to whole-person primary care can play in battling against chronic illnesses, such as Type II diabetes and cardiovascular disease.
Panelists included Bethany Franklin, MD (UPMC Central PA), Kathleen Findlay, MD (Western Wisconsin Health) and Tom Bateman, PharmD (Henry J. Austin Health Center) with Ann Greiner (Primary Care Collaborative) moderating.
Before diving into the webinar, the PCC would like to remind viewers of the organization’s upcoming 2025 Conference: Scaling What Works for Better Health. Taking place in DC from June 4-5, this conference will host compelling conversations exploring how innovative new approaches to primary care delivery and payment may be successfully scaled. You can register for the event here.
Dr. Findlay began by emphasizing how effective care coordination requires a personalized, team-based approach rooted in lifestyle medicine. She highlights the importance of addressing social determinants of health and ensuring clear communication across all care providers to support patient-centered treatment goals. Dr. Franklin echoed this sentiment, highlighting the strong link between mental and physical health and the value of meeting patients where they are.
Dr. Findlay then underscored the importance of team trust, role clarity and coordinated care, highlighting her focus on lifestyle medicine while relying on primary care colleagues for medication management and other needs. Bateman explained how he builds trust with patients through motivational interviewing and open-ended questions. He focuses on listening first, understanding patients’ goals and then collaboratively developing a care plan. This ensures shared decision-making and clear communication throughout.
Dr. Franklin highlighted the high physical health risks faced by people with severe mental illness and advocated for integrated care models that combine mental and primary care in trusted settings to improve outcomes and reduce early mortality. Dr. Findlay agreed, stressing the need to create safe, trusted spaces for patients and partnering across settings. She noted that when patients feel a sense of belonging, they’re more empowered to make positive changes.
The three then discussed their support of payment reform to support non-dispensing services and team-based care. They called for flexible, value-based models that reflect local needs and ensure all providers are reimbursed. This would allow primary care clinicians to focus on building strong, lasting patient relationships.
Dr. Findlay implored the use of all tools, including medications, lifestyle changes and therapy, in personalized, team-based care. Dr. Franklin added that walking alongside patients in medication decisions is key, supporting them through open conversations and safe, gradual changes. Both emphasized meeting patients where they are and keeping care flexible and patient-centered.
Dr. Bateman explained how regularly reviewing and updating medication regimens at every patient visit can address therapeutic inertia. He recommends using a fresh, patient-centered approach to optimize treatment, including considering new therapies, costs and side effects.
To close, Bateman, Dr. Findlay and Dr. Franklin reiterated the need for personalized, team-based care that meets patients where they are, supports open dialogue and continuously adapts treatment to best serve patients’ needs.
Below are resources from the webinar: