Mitch

It’s relational. It’s based on a relationship, right?

Jack

They’re assigned 25 mother-child pairs. If they had 50, would it work?

Jeremy

It’s just about how many patients a primary care doctor can see without pulling all their hair out.

Warren

I would like to take our conversation in a different direction. The question I have for us in family medicine (and I’m sorry to be provincial) is how do we broaden our tribe? And one of the questions for us is: Do we include other specialties in internal medicine and pediatrics? On balance, it was a tremendous asset for us. The politics are different in different specialties. We made the mistake of not including Duke to begin with. Duke doesn’t like to be a part of anything that they’re not running. In family medicine, collaboration is okay, but Duke general internal medicine didn’t want to participate. But the community medicine programs really were very good participants. They brought projects related to hospital medicine to the table, and they cared a lot about the data. So they brought a group of people who would always track the data and make the group smarter from that point of view. The pediatricians were really focused on faculty development, so they would often talk about faculty development, and that was very positive. While they recognized that there was a lot of overlap between family medicine and general medicine, in the end, they felt like there was not as much overlap between family medicine and pediatrics. Pediatrics itself was going in this more subspecialty direction. But for us, it was the question of how we build a tent in which there are more people. Psychiatry comes to mind. The cultural gap with general surgery is pretty large, but if you want to take care of rural areas, you must involve general surgery. This kind of collaboration may not work as well with general surgery. But the question is: How do you get not just family medicine doing this?