Do you have a ‘medical home?’
BY CHRISTOPHER HAGER, MD
“Heart of the Matter”
Lancaster General Health
A personal physician who heads a team of professionals who will treat your illnesses, show you how to prevent diseases, manage any conditions you may have, and coordinate specialized care if you need it?
With demand for health-care services increasing, costs rising, and a population that’s aging, the concept of the “medical home” is gaining traction as a way to deliver effective and efficient health-care services.
How does it differ from your primary-care physician’s practice today?
The “medical home” is essentially a team approach to health care, rather than the one-to-one approach you’re used to. Your physician is at the heart of the team, but you will not necessarily see him or her at each office visit. Depending on your needs, your appointment may involve a nurse practitioner, physician’s assistant, nurse, medical assistant, nutritionist, or social worker.
Unlike managed care, the “medical home” is not a gatekeeper to specialists. It offers continuous care throughout your life and a seamless transition to specialists who will evaluate, diagnose, and treat complex conditions.
It puts you, the patient, at the center, coordinating and providing access to all parts of the health-care system—hospitals, specialists, home-health agencies, nursing homes, and public and private community-based services.
Since its introduction in 1967 by the American Academy of Pediatrics, the “medical home” has been embraced by other groups, including the American College of Physicians and the American Academy of Family Physicians, who have promoted their own models to improve patient care, reduce costs, and set quality standards.
Some early results from pilot projects are promising. In 2009, the Geisinger Health System in northern Pennsylvania reported a 14 percent decrease in hospital admissions, improvements in diabetes and heart disease care, and a 9 percent reduction in costs.
Another report on 36 practices participating in a national demonstration project showed patients generally were pleased—if they understood what was going on and why they weren’t necessarily seeing their doctor every office visit.
What’s important for us to remember is that we in the medical community and you as a patient need to work together to forge a new way for the future. The facts are that health-care expenditures in the United States significantly exceed those of any other developed country, and yet in one study, our quality ranked at or near the bottom in nine of 10 categories.
While the “medical home” is a work in progress; it is an idea worth trying.
Christopher Hager, MD is a Family Physician who practices at Lincoln Family Medicine in Ephrata, Pa. He is currently president of the Lancaster City and County Medical Society. He also serves as a board member for the Lancaster County Medical Foundation which runs the “PALCO” project for patients without health insurance, and senior physician leader for the Lancaster General Medical Group (LGMG).