Shirah Vollmer MD

The Musings of Dr. Vollmer

Patient Centered Medical Home

Posted by Dr. Vollmer on November 8, 2010

     Patient Centered Medical Home, new wine in old bottles, maybe. Where did the days go of Marcus Welby MD? Where is the country doctor who took care of generations of family members, attended funerals, came for family dinners? Do we want those personal days back in our health care system? The home visit, the deep trust and the compassion seems to have withered away with a greater reliance on technology and a greater influence of health insurance companies. The introduction of the phrase “patient centered medical home” is designed to re-introduce the public and the insurance companies about the value of primary care, the value of a doctor who really knows their patient. For most of us, this seems intuitive, but in point of fact, the evidence that more personalized medical care is better medical care is lacking. Health services research might prove that it is indeed cost-effective to have a doctor know your personality, but for now, it remains a luxury that we who have grown up with this care, have come to expect. When we are sick, we regress; we return “home”. The use of the word home in this new phrase suggests that sick people need a warm place to go to. Whether that warmth needs to be supplied by the physician or by caring family members or both is hard to say. The identity of the primary care physician evolves as technology and culture change. Change is a neutral term, but it engenders fear. Patient centered medical home, the wording, calms us down. It may also be a positive turn to the past; recreating the village of caring and personal service.

4 Responses to “Patient Centered Medical Home”

  1. Kristin said

    Where is this concept coming from? When insurance companies use this sort of language, my hackles go up because it usually means more restrictions on treatment options, less freedom to select particular specialists, and more hoops to jump through to get an appointment.

    I guess the other end of the spectrum are those walk-in clinics that are popping up at CVS and other chain pharmacies.

    • I am not sure. My point is to say that although it feels good to have a primary care doctor know who you are, in the end, it may make no difference to your health care. Yes, terminology can mislead; a home may indeed be an unwelcome place for folks with more complicated medical issues.

  2. Shelly said

    I’m with Kristin. In my neck of the woods, we have very few options for primary care doctors. We don’t really “get to choose” one but rather, are limited to one who is available. It’s less like “going home” than going to the one of last resort. Ugh.

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