The world of primary care was galvanized in 2007 by the publication of the Joint Principles of The Patient-Centered Medical Home (PCMH) that spells out the fundamental features of a primary health care setting in which a team of clinicians offers accessible first-contact primary care. 1 This care should be personal, coordinated, continuous, and comprehensive-it should address most or all of a person's health care needs. Comprehensiveness confers value to the PCMH, and is an especially important principle. 2 By some means, "all of a person's health care needs" must be addressed in the PCMH. This cannot be achieved without including the behavioral aspects of health. Yet comprehensiveness often is not achieved in PCMH efforts because behavioral issues are not addressed. This shortfall requires redress.

Background: One potential psychological construct, grit, may help to explain the non-cognitive traits that account for both rural physician satisfaction and retention. We investigated (1) the psychological construct grit among rural and non-rural primary care/specialty care physicians, (2) satisfaction levels and (3), the relationship between the psychological construct grit and satisfaction across combinations of rural/non-rural and primary care/specialty care physicians.Methods :

The world of primary care was galvanized in 2007 by the publication of the Joint Principles of The Patient-Centered Medical Home (PCMH) that spells out the fundamental features of a primary health care setting in which a team of clinicians offers accessible first-contact primary care. 1 This care should be personal, coordinated, continuous, and comprehensive-it should address most or all of a person's health care needs. Comprehensiveness confers value to the PCMH, and is an especially important principle. 2 By some means, "all of a person's health care needs" must be addressed in the PCMH. This cannot be achieved without including the behavioral aspects of health. Yet comprehensiveness often is not achieved in PCMH efforts because behavioral issues are not addressed. This shortfall requires redress.

The LIFE (lifestyle change, individual readiness, fitness excellence, eating healthy) wellness program was an intensive, out-patient, healthy lifestyle change program with participants from the Army, Navy, Air Force, and Marine Corps. Our objective was to describe the LIFE program and to present before and after test results for this 1-year program. Fifty-three participants completed the 5-day intensive outpatient and 1-year follow-up program and maintained average weight losses of >10 pounds and 14 pounds for men and women, respectively. Most of the weight loss occurred by 6 months. Participants who completed the program also showed increases in healthy eating attitudes, well-being, and overall quality of life. The LIFE change model has implications for improved service retention, health, and overall quality of life or patient evidence that matters (POEMS). The program is both portable and flexible and can be tailored to the demands of the dynamic military environment.