A simpler primary care system has advantages

By Dr. Elizabeth Smoots
Herald Columnist

Do you find that your medical care is sometimes confusing, disorganized and complicated? Our fragmented health care system offers such an assortment of providers, tests, treatments and procedures — each with its own set of paperwork and bills — that it’s difficult to keep track of it all.

Could there be an easier way? Some of the nation’s leading medical groups have come together to propose a model for addressing many of our health care ills. It’s called the patient-centered medical home.

What is a medical home?

The patient-centered medical home is an approach to providing comprehensive primary care for people of all ages. Each person is encouraged to form a close working relationship with a primary care physician who knows them well. Since family physicians, pediatricians and internists are trained to follow the overall health of their patients over time, they are especially well-suited to assume the role of medical team leader in the lives of their patients.

The medical home model transforms the traditional doctor’s office into a center where Americans can get personalized advice from a provider they know well for most of their health care needs. To fulfill the definition of a medical home, this care should be accessible, continuous, comprehensive, family-centered, coordinated, compassionate and culturally sensitive.

What are the advantages?

Having your health care provided continuously by the same physician over time can lead to better disease prevention, better coordination of care and better overall health.

“Research has shown that primary care matters in terms of access, cost and quality,” said Dr. Rick Kellerman, board chairman of the American Academy of Family Physicians. “Patients who have an ongoing relationship with a primary care physician have better outcomes and lower costs. When care is managed by primary care physicians in the ambulatory (outside of the hospital) setting, patients with chronic diseases have fewer complications, which leads to fewer avoidable hospitalizations.”

It’s easy to understand that it’s important to have a physician who knows you if you get very sick and need a lot of medical attention. This way, there’s less chance you will be put through unnecessary and costly tests and procedures. In addition, your personal primary care provider is more likely to understand you as a whole person. Your priorities and health care needs, as well as any emotional, family or relationship issues that are involved in your situation can all affect your health care. For optimum care, it’s definitely an advantage to have a provider who knows a lot about you.

How new is the concept?

The American Academy of Pediatrics introduced the medical home concept in 1967 as a way to improve the care of children with special needs. In 2004, the American Academy of Family Physicians expanded on the idea when it recommended that every American should have a personal medical home. Then this year, both agencies, and the American College of Physicians and the American Osteopathic Association, representing about 333,000 physicians, developed joint principles to describe the characteristics that make up the patient-centered medical home.

The U.S. Congress is currently debating the medical home concept and several pilot projects are in progress nationwide. For now, forming an ongoing relationship with a particular primary care physician within a medical practice is probably the best place to call home.
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