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  • The National Center for Primary Care (NCPC) of Morehouse School of Medicine has the unique distinction of being the only congressionally sanctioned center in the country dedicated to promoting optimal health care for all, with a special focus on serving underserved communities.

    As a national center, our interests are many. The center seeks to be a national resource for improving primary care education and research in order to provide opportunities for health-care professionals throughout the country. Currently, our primary areas of work target the elimination of health disparities, resulting in an overall reduction of cost for care for all Americans.

    The National Center for Primary Care has been very active in developing educational programs for primary-care clinicians in safety net settings. Most prominent is our annual Morehouse School of Medicine Primary Care and Prevention Conference. This program has received funding from AHRQ, CDC, and NIH, as well as a private sources such as pharmaceutical companies. Each year, several hundred primary-care and public health of professionals attend this conference, and highlights are posted on the NCPC web site. Articles are generated for a special supplement of Ethnicity and Disease, which assures that they are then available (including abstracts) in a Medline searchable format.

    Training

    Our Southeast Addiction Technology Transfer Center (SATTC) conducts or co-sponsors training programs for community members, addiction counselors, and other behavioral health professionals. The SATTC also graduated 18 proteges from the charter class of their year-long Leadership Institute program. The SATTC also sponsored its Annual Faith Community Conference entitled, "Integrating the Sacred & Secular Treatment of Addiction... "It's a Family Affair."

    Another area of teaching strength for the NCPC is in the area of cultural competency. A description of our CRASH-course in cultural competency has been published in a special supplement to Ethnicity and Disease. Several of our faculty have led workshops using in the CRASH-course curriculum, teaching primary-care clinicians' and public health professionals from across the state of Georgia in a variety of venues. The CRASH-course model (C = culture, R = respect, A = assess/affirm, S = sensitivity/self awareness, and H = humility) has also been taught by Dr. Satcher in various speeches, in the context of eliminating health disparities and in and addressing mental-health needs in a culturally sensitive matter.

    Education

    Within Morehouse School of Medicine, the faculty of the National Center for Primary Care are active in teaching both in the MD and the MPH programs. Individual faculty members teach specific lectures and precept in clinical settings. Dr. Rust serves as course director for the 4th year student elective in academic medicine, as well as for residency rotations in community health and practice management. Dr. Kondwani leads a course for MPH students on complementary and alternative medicine. Perhaps our largest single contribution to education within the institution is through our faculty development program. In January 2006 we published the evolving methods and the ten-year outcomes of this program, which is now actually in its 14th year. Several of our clinical departments have had 100 percent of their faculty participate in the faculty development program, which has now generated more than 135 graduates, and is the leading producer of African American clinical faculty in the nation.

    Research

    Over the past 10 years we have cultivated partnerships with community health centers throughout the southeastern United States to engage in research to improve care and outcomes for the low-income populations that they serve. Initially funded by AHRQ as a practice based research network, the Southeast Regional Clinicians' Network has engaged in studies related to asthma, diabetes, and depression. Our community oriented primary-care team at the National Center for Primary Care (led by Dr. Ellie Daniels) is the sole academic partner for this network. The focus is to improve quality of care and outcomes in real-world primary-care settings that served high-disparity patient populations. The complexity of these studies has ranged from simple surveys of medical directors all the way to pilot projects of quality improvement interventions all the way to a multi-state group randomized controlled trial of a quality improvement intervention related to asthma.

    These studies have been published in peer review journals such as the Journal of Asthma, Journal of the National Medical Association, and JAMA. Analysis of large data sets on Medicaid and the uninsured gives us the power to measure health outcomes at the level of communities in need. In this arena, we have published studies of disparities in the treatment of depression in the elderly and in pain management during labor.

    Over the years, we have cultivated this capacity for analyzing Medicaid data, and have in fact taught health services researchers from all over the country how to use Medicaid data for research. With the recent release of data from all 50 states, we are well-positioned to be the leading institution in the nation for analyzing disparities in the U.S. Medicaid population. The NCPC has now also obtained access to a 100 percent sample of hospital discharge and emergency department visit data for the state of Georgia. This will allow us to conduct unique studies at the local area level (county or zip code) of the impact of having or not having a cohesive primary-care safety net on the incidence of emergency room visits and hospitalizations for primary-care sensitive conditions. In our recent partnership with a company that won a state contract for Medicaid disease management among all the blind & disabled Medicaid clients in northern Georgia, we now have the challenge of bringing all this work together by improving care and outcomes for a high-disparity patient population, using health outcomes data to generate rapid-cycle feedback loops. In other words, we have to move the needle on human suffering, measurably reduce health disparities, and then prove it with academic rigor. This has been our research strategy or long-term plan, which is to test interventions in real-world settings, but to develop access to outcomes data at the population level to show that indeed disparities are not inevitable, and to prove methods for reducing or eliminating disparities community-wide.

    Service

    Our NCPC-based faculty are involved in service on a number of levels, although limited in direct patient care. During 2005, Dr. Rust precepted one half-day per week in the Family Medicine Dept.'s Comprehensive Family Health Center in East Point or in the Grady General Medicine Clinic. NCPC faculty are more typically involved in service through their support for front-line clinicians or community-based organizations. For example, the NCPC Maternal-Child Health Team Leader, Dr. Yvonne Fry-Johnson, also serves as the Clinical Director for the Georgia Association for Primary Health Care, representing all the federally-funded community health centers in Georgia. Dr. Elvan Daniels provides is a clinical leadership resource for the Southeast Regional Clinicians' Network, representing 146 community health centers in eight southeastern states.

    This brief introduction to the National Center for Primary Care is just a small sample of who we are and who we seek to become. We hope that we will be able to meet with you and others with whom you interact to develop a meaningful partnership and share in the challenge of shaping a healthier nation.