"A paradox persists when the paradigm is wrong": Pisacano scholars' reflections from the inaugural starfield summit

Noemi Doohan, Anastasia J. Coutinho, Jennifer Lochner, Diana Wohler, Jennifer DeVoe

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


The inaugural Starfield Summit was hosted in April 2016 by the Robert Graham Center for Policy Studies in Family Medicine and Primary Care with additional partners and sponsors, including the Pisacano Leadership Foundation (PLF). The Summit addressed critical topics in primary care and health care delivery, including payment, measurement, and team-based care. Invited participants included an interdisciplinary group of pediatricians, family physicians, internists, behaviorists, trainees, researchers, and advocates. Among the family physicians invited were both current and past PLF (Pisacano) scholars. After the Summit, a small group of current and past Pisacano scholars formed a writing group to reflect on and summarize key lessons and conclusions from the Summit. A Summit participant's statement, "a paradox persists when the paradigm is wrong," became a repeated theme regarding the paradox of primary care within the context of the health care system in the United States. The Summit energized participants to renew their commitment to Dr. Starfield's 4 C's of Primary Care (first contact access, continuity, comprehensiveness, and care coordination) and to the Quadruple Aim (quality, value, and patient and physician satisfaction) and to continue to explore how primary care can best shape the future of the nation's health care system. (J Am Board Fam Med 2016;29:793- 804.).

Original languageEnglish (US)
Pages (from-to)793-804
Number of pages12
JournalJournal of the American Board of Family Medicine
Issue number6
StatePublished - Nov 1 2016


  • Family
  • Family practice
  • Forecasting
  • Leadership
  • Personal satisfaction
  • Physicians
  • Primary health care
  • Research personnel
  • Writing

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Family Practice


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