What value does the patient-centered medical home bring to physicians?
This entry is a natural corollary to my last post. The medical home is supposed to be patient-centered, so naturally we would consider the value to patients first. However, we found there to be tremendous benefits to us as physicians as well. Our practice is composed of female physicians who are all part-time and have young families. Completing our patient care duties on time and going home at 5 p.m. are unspoken values we protect. Our staff is right in line with protecting these values as well.
Organizing the practice service model around the components of the medical home (i.e., team-based care, attention to preventive care and chronic disease management, empowering clinical staff to carry out protocol driven services, open access, etc.) really helps the efficiency of the practice. All providers in our practice found it easier to begin on time, stay on time, complete all requested and necessary services during (and around) a visit time, and finish on time. Sure, we still have chaotic days when we cannot be quite as efficient. What primary care practice doesn’t? However, chaos is not the rule in a well-functioning medical home.
We might make more money. At least we make the same for less time spent working. In our setup it is difficult to tell because we're on a modified salary/RVU productivity/quality incentive compensation model. However, we are all very pleased with our part-time salaries and benefits and compare very favorably with national benchmarks.
We have made time to take care of patients between visits. We have time to research patient conditions. We have time to “consult” with consultants, asking questions and learning new things. We have time to read and do CME at the office. In fact, time may be a more important commodity to us than money and we are thrilled to have found a way to create more of it.
There is something positive and hopeful about practicing medicine on the crest of this wave. My partners and I have tremendously enjoyed networking with other like-minded physicians around the country as we have struggled and succeeded in implementing a medical home practice. Now we teach others ways to improve their practice experience, which is something we love doing.
–Melissa Gerdes, MD