1. The need for team facilitation – “The intense pace and magnitude of change soon revealed and exacerbated deeper dysfunction within the relationship infrastructure of practices, including tension among physicians and among practice staff, ineffective communication patterns, and avoidance of conflict and difficult conversations that produced stalemate.”
2. Practices need assistance with the transformation – “This endeavor requires new tools, workshops, and other learning and personal development formats to help physicians transform within themselves and in their relationships with their practice partners, patients, health care systems and communities.”
*. Nutting P, et al. Initial Lessons from the first national demonstration project on practice transformation to a patient centered medical home. Annals of Family Medicine. 2009;7:254-260
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