So what exactly is this new “Patient Centered Medical Home” (PCMH) and why has it become  the new buzzword for healthcare reform? Matter of fact, it is mentioned at least 15 times in the recent healthcare reform legislation.  Recognizing that having access to primary care is the key to improving healthcare outcomes, everyone from payers, purchasers, physicians and patients are hoping that the medical home will improve quality and drive down healthcare costs.

The PCMH addresses the inadequacies of our current care system that are experienced by patients every day—difficulty in making an appointment in timely fashion, poor communication between patients and physicians and their staff, receiving timely test results, repetitive paper work requirements, having to see multiple different providers-“I never get to see my own doctor when I’m sick” and endless wasted time in the waiting room only to spend more time in the exam room as you wait for the hurried doctor and staff to spend some actual face to face time with you. I’m sure you can come up with your own list of inefficiencies and frustrations—I hear them from patients and friends and family every day.

The Medical Home is characterized by 7 key attributes:

1. Everyone has a personal physician

2. The physician leads the office based team effort

3. There is a whole person orientation to care

4. Care is coordinated

5. There is an emphasis on quality and patient safety that is measured and reported

6. Access to care

7. Payment restructuring, a fee for service reimbursement incents the “wrong” type of care

Sounds great doesn’t it? Yet, terms like coordination of care, access to care and quality are relative,  subjective and confusing to many—especially when every health care organization claims to deliver the ‘best care.’

So how does a Medical Home look and feel? Here are 5 questions that can serve as a reality check:

1. Do a get the care when I need it?

2. Do I receive care from a physician and staff that know me?

3. Does my physician manage the bulk of my health care needs?

4. Does my physician coordinate any care/tests that I need outside    of the office setting?

5. Does the physician/ office share quality and practice improvement results with me?

May sound simple, but transforming care is a monumental undertaking. A recent 2 year study showed that a Medical Home may improve some outcomes but the patient rating of the medical home experience was termed ‘disappointing.’ http://www.medscape.com/viewarticle/723086?src=mpnews&spon=34&uac=79313PN)

Why?—looks like the emphasis on technology and electronic health records adversely affected the interpersonal part of the visit experience.  It serves as a reminder that with the all the changes in the healthcare system the foundation of care remains the physician-patient relationship.