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Thursday, January 27, 2011

What value does the patient-centered medical home bring to patients?

A prospective medical home adopter recently asked me: “What do your patients think about being part of a medical home?” I immediately responded: “They love it!” However, after thinking about this question further, my honest answer is that most of my patients do not realize what a patient-centered medical home (PCMH) is or that when they come to our office they are in one. I decided to informally survey a few patients to confirm my suspicion. The results? Only one even knew that we “were involved in some study thing ... involving the medical home.” And even this patient may only have known because we have fliers and newspaper clippings around the office about the PCMH. This got me thinking, what do patients gain by belonging to a PCMH? I came up with the following:

  • One-stop shopping for medical needs. People lead very busy lives these days and any model that helps them package things they need in one place is valuable (look at Wal-Mart, for example).
  • Continuous care with a personal physician who knows them well. According to several studies, Americans value having a personal physician. The benefits are real but are difficult to quantify.
  • Easy access to your family physician and his or her team of caregivers. Technology and improved efficiency in office processes brought about by the PCMH allow more appointments. Medical home offices ensure patients have access to these appointments in innovative ways.
  • Continuity of care between office visits and across dimensions of health care. A sense of security develops when patients know there is a stable team behind them planning for care even when that care occurs outside of the physical team environment.
  • Behind-the-scenes care. Preventive reminders and adherence to evidence-based guidelines happens seamlessly. This is why patients often don't realize they are part of a PCMH.
  • Access to improved technological management of care. Americans love technology. Medical homes use this technology to proactively organize and take more complete and scientifically founded care of patients.

We can also learn from pilots going on around the country. Group Health in Washington found that patients involved in a medical home were significantly happier with their experience. In many pilots, assessments of patient experience and opinions are lacking or ongoing. In future years, we look forward to hearing more from the center of the medical home: the patient.

–Melissa Gerdes, MD

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About the Author

Melissa Gerdes, MD, is a family physician practicing at Methodist Family Health Center – South Arlington in Arlington, Texas, and former president of the Texas Academy of Family Physicians.

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