Reimagining Our Relationships with Patients: A Perspective from the Keystone IV Conference

Substantial efforts to redesign health care delivery are underway in the United States, including primary care, without attention to what has historically been known as “the personal physician.” The American Board of Family Medicine Foundation convened the Keystone IV Conference to reflect on the nature of personal doctoring and particularly what promises personal physicians might appropriately make and keep with their patients, going forward in new systems of care. This commentary describes the conference and its participants and provides an overview of manuscripts prepared by attendees that together comprise a written record of the conference. The authors conclude that a properly prepared and positioned personal physician practicing within a modernized primary care platform is a critical means of achieving better health and health care that is affordable, revitalizing the health professions workforce, and restoring population health in the United States. There is urgency to join with patients and colleagues to create the conditions under which people can have a personal physician of their choosing who knows them well, will stick with them as they wish, and be accountable for their receiving care that is appropriate for them as unique persons, with particular goals, preferences, and capabilities.