What’s in an (awkward) name: Why “medical homes” would improve health care in Connecticut
Today’s guest post is by Ignatius Bau, a consultant to the Connecticut Health Foundation and leading strategist in advancing health equity through the medical home concept.
A recent article in The Connecticut Mirror (“Study finds confusion about medical home concept”, October 12) described the understandable confusion about the concept of “person-centered medical homes”, which is to be implemented in Connecticut in 2012. Despite the awkwardness of the name, the idea of having “one provider who coordinates all your health care” is something that will be good for Connecticut.
Ironically, this concept is not a new one but one that emerged in the 1960s among pediatricians caring for children with special health care needs: children with physical or developmental disabilities, children who became sick with rare cancers and other diseases. These doctors recognized that they only were one part of a much larger team of health providers for that child and his/her family.
These children – and their parents, family and caregivers – needed coordination and ongoing communication with lots of specialists, hospitals, rehabilitation facilities, schools, child care, transportation, recreation programs, housing, and many, many other health and social service providers. The child’s doctor had a vital role as the team leader among all these other providers, as the “home base” where the child and family could always “go home” for advice, referrals, and support. The doctor’s office would be a place that was familiar, where there was a long-term relationship of trust, where the needs of that child and family were well-known, and would be taken care of.
It was also really important that the child not be viewed as just a patient with a disability or just a patient with cancer, but as a whole person, who had many needs to function well and thrive, beyond medical care. Thus, the concept of a child-centered medical home was born.
Over time, pediatricians realized that this concept was a valuable one for not just children with special health care needs, but for all children. Other doctors who took care of adults, especially those with chronic conditions and seniors, also joined the chorus supporting patient-centered medical homes for every patient.
The concept has continued to evolve and now has many names: health homes, primary care medical homes, advanced primary care practice. Connecticut will call them person-centered medical homes.
But yes, we need to work on how to communicate this concept to Connecticuters. Here is how a conversation from your current provider (either doctor, nurse practitioner, or physician’s assistant) might go:
I’m excited to be part of a statewide program to improve health care here in Connecticut.
From now on, I will be the one provider who coordinates all your health care.
You can expect, and rely on me, to know everything that I should about you and your health, and we will work together over time to improve your health, and make sure that you get the best health care you need. I will share information with you so that we can make decisions together about your health care and your health.
I will introduce you to my office staff and explain how they will be helping me to help you. My staff will work as a team to provide the best care and services that we can.
Even when you need to go see other doctors such as specialists, or have to go to the hospital, I will always be here for you, as your provider that is responsible for taking care of your health.
If you ever have any questions or need anything related to your health care, you can always ask me. I am going to be your personal provider who wants you to be the healthiest and happiest person that you can be.
Do you have any questions?
If we explain person-centered medical homes – and implement them – in this way, all Connecticut residents will be healthier and happier.