Have you heard about the “Patient-Centered Medical Home”? This is not a home, per se, but rather an approach to provide more holistic and longitudinal care to all Americans. Developed jointly by the American societies for internists, family physicians, pediatricians and osteopaths, the purpose of this model is to improve overall health care in the US.
Much of our current health care is “fractured” – doctor visits for acute problems without adequate long-term follow-up or preventive services. Primary physicians and specialists often don’t work in concert. Important community resources are underutilized.
The patient-centered medical home philosophy aims to create a model of longitudinal care that looks at the whole person and views their health within the larger societal structure. It is based on our model for care of chronic illness, but applied to “well” people as well. Each person should have access to a health advocacy team led by a primary care physician. This team will utilize prevention, education, technologic advances and community resources to help each person maximize his or her well-being.
The obvious challenge is the rapidly declining number of physicians who are entering general practice. In order for this system to take hold, we must support generalist physicians and restructure our reimbursement system to better value those who promote and maintain good health, not just the high-tech doctors who treat problems after the fact.