Doctors Promote “Medical Homes” as Way to Take Us Back to the Future
Many Dark Daily readers remember “Marcus Welby, M.D.” This popular TV show ran from 1969 to 1976 and starred actor Robert Young in the role of Marcus Welby, M.D. His sidekick was assistant Steven Kiley, M.D. (played by James Brolin). Dr. Welby was the dedicated family practice physician who treated patients as individuals in an age of specialized medicine and uncaring doctors.
Now, there is a movement among physicians to return to the caring compassion displayed by Marcus Welby, M.D. These physicians are endorsing a new model of patient care known as the “medical home.” The medical home is gaining momentum nationwide as an alternative to the current system of jumbled provider networks, says the Association of American Medical Colleges (AAMC). In addition to the AAMC, such organization as the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians, and the American Osteopathic Association, are promoting the concept of the medical home.
The AAMC defines the medical home as one that: 1) includes an ongoing relationship between a provider and patient; 2) provides around-the-clock access to medical consultation; 3) respects a patient’s cultural and religious beliefs; 4) provides a comprehensive approach to care; and, 4) coordinates care through providers and community services.
The medical home model puts the emphasis on primary care. It changes reimbursement to physicians so that they have an incentive to promote the early detection of illness and active intervention. This is similar to a major effort by the United Kingdom’s National Health Service (NHS). In recent years, the NHS has shifted funds away from acute and specialist care at the hospital trusts and transferred those funds to primary care trusts. In this way, the NHS has made primary care physicians responsible for early diagnosis, as well as pro-active management of patient care.
On July 21, USA Today reported that, here in the United States, individual states, the federal government, and private insurers are experimenting with ways to pay primary care physicians more money to oversee and coordinate patients’ care. The federal Centers for Medicare & Medicaid Services plans a demonstration project in 2010 to test whether paying primary care doctors more per month to treat patients with chronic illnesses in medical home settings results in better care and lower costs, compared with traditional clinical practices. The Tax Relief and Health Care Act of 2006 (TRHCA) mandates a demonstration in as many as eight states. This demonstration project will provide targeted, accessible, continuous, and coordinated family-centered care to Medicare beneficiaries who are deemed to be high need (that is, with multiple chronic or prolonged illnesses that require regular medical monitoring, advising or treatment.)
If the patient-centered medical home concept gains support, it could mean that clinical laboratories will see a greater demand for near-patient and point-of-care testing capabilities. That’s because, as caregivers visit patients in various settings, including patients’ homes, caregivers will want both fast access to lab test results and the ability to view those test results remotely.
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