Reducing Administrative Burden

July 13, 2022

Below is a recent interview conducted with Dr. Sara Pastoor who currently serves as the Director of Primary Care Advancement at Elation Health, where she advocates for primary care and the powerful impact of technology on the care delivery experience and outcomes. Dr. Pastoor is a clinically active physician executive with 20 years of experience in primary care innovation, patient-centered medical home, health system transformation, organizational change management, population health, EMR optimization, quality improvement, and health technology. She is a Fellow of the American Academy of Family Physicians and spent the first 15 years of her career in the Army Medical Department. Dr. Pastoor has also led patient-centered transformation and primary care expansion in the academic and employer-sponsored primary care settings.

Tell us about your experience in primary care.

I have always been drawn to the biopsychosocial model of medicine, and I knew early in medical school that I belonged in family medicine because I wanted to care for a “whole person” in the context of a family and a longitudinal relationship. My undergraduate degree was in psychology, and I eventually sought a residency program which had a deliberate focus on the integration of mental health services into primary care.  I found this at Baylor College of Medicine in Houston.  After residency, I owed the Army some active duty time to pay back a scholarship for medical school.  My first duty assignment was at San Antonio Military Medical Center in 1998, where I spent years working under the mentorship of Dr Catherine Sauri, an unsung primary care hero who was ahead of her time.  She was delivering patient-centered primary care with an interprofessional team (family docs, NPs, PAs, psychologists, a nutritionist, a clinical pharmacist, a nurse educator, care coordinators, and physical therapists) way before it was cool.  I was so fortunate to learn about primary care from Cathy, who later died shortly after being diagnosed (at work!) with glioblastoma multiforme.  

I spent 15 years working for the Army as a family physician, holding a variety of leadership positions, helping lead the Army-wide patient centered medical home movement, innovating on the technology side, reinventing metrics, working in quality and patient safety, and various other pieces and parts of the healthcare system which impacted or influenced primary care – always a vocal and unapologetic advocate for primary care.  I never stopped working on the front lines of primary care and advocating for what providers needed to take better care of their patients.  

After a brief detour into the academic system, where I was hired to optimize and amplify non-teaching primary care operations, I later joined Crossover Health, one of Elation’s biggest customers. Crossover is really on the cutting edge with their technology-rich, employer-based delivery platform built around an exceptional patient experience.  I absolutely loved both leading and practicing medicine in the Crossover model, with the added bonus of getting to use Elation!

Today, I am part of a Direct Primary Care practice part time, and I volunteer in a free clinic, teaching students and providing primary care for members of my community who are uninsured/unfunded.

What brought you to this position at Elation OR what do you hope to accomplish in this position?

When I learned about this position at Elation, I had never felt more excited about a job opportunity in my life!  This role brings together my biggest professional passions: primary care, technology/innovation, and advocacy.  The position exists to advocate internally and externally for the value of primary care for patients, payers, and the healthcare system. I hope to work collaboratively with our customers and other primary care leaders to help design the future of primary care in America, elevate primary care to its crucial position in society, and drive a collective strategic plan to get there, with Elation as the vehicle of transportation. 

What are you most excited about in the changing independent primary care landscape?

Primary care is hot right now! We are gaining some momentum at the policy level, and the recent report from the National Academy of Science, Engineering and Medicine Implementing High Quality Primary Care, coupled with the Commonwealth Fund’s recent and 7th report showing the failings of the American healthcare system (largely related to a lack of primary care), are setting the tone for action.  

The pandemic has been an unprecedented challenge to the entire industry, and primary care has never been more important to our communities.  There has been a huge injection of venture capital into innovative primary care models all across the country.  Payers are beginning to inch away from traditional payment models towards models that pay for value.  I’m excited about the Primary Care for America initiative, sponsored by the AAFP, and the Measures that Matter initiative, sponsored by the ABFM. Change is hard, and we have a long journey ahead. To get there, we need to invest in primary care more and differently, and change how we assess primary care contributions to reflect its true value without inflicting more burnout.  Elation Health is “all in”, and I’m more hopeful than ever that a brighter future is on the horizon.