| System and practice-level changes | Restructure payment systems to better support work done outside the exam room and not face-to-face (E-mails, phone calls), mental health care, coordination of care, long-term continuous relationships. Incentivize relationship building. Use electronic medical records and other technology to facilitate communication and to improve rather than detract from relationships. Build team, restructure clinic work flow. Educate patients and the public about the feasibility and value of having a personal physician and the need for advocacy for system change to make this widely possible. Appropriately sized (smaller) patient panels. Change medical school education—teach trainees to ask for patient’s perspective. More actively coordinate care and avoid redundant and wasteful care.
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| Individual-level changes: “One thing I’m going to do now.” | Add personal touches (eg, attend funerals, send birthday cards). Put the focus back on the relationship. Ask patients at least one non-health care question about hobbies, family, etc.; ask about personal goals; take social histories; listen longer in the beginning. Self-assessment and self-reflection: Ask self: “When am I my patient’s doctor? Am I the type of doctor I want for myself and family?” Recommit to being a personal physician. Teach residents to ask for patient perspective. Make sure patients know their team and use their team. Assess how electronic medical records and other technologies are helping or hindering patient relationships. Create price lists and post them. Increase involvement in the community; build flexibility into schedule for community involvement.
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