Comments on: How the patient-centered medical home can improve our health care system

By: Carla Kakutani MD

Carla Kakutani MD — Mon, 19 Oct 2009 00:39:02 +0000

The organizations supporting the medical home know that not everybody is going to want to change. But for those of us who want to see our country benefit from the value medical home and strong primary care can bring, we welcome Dr Grundy’s leadership. The concierge practice model may work for some, but I’m holding out for a solution that benefits more than the select few patients that can afford that.

By: rbalboajrmd

rbalboajrmd — Sat, 17 Oct 2009 18:55:31 +0000

Agree with christophil M.D. Hate to say it but PCMH is doomed to fail. Still way too much bureaucracy. Still not going to attract med students into primary care.
Direct pay patient-doctor primary care is affordable and valuable.
As proven over the last 15yrs, indirect payers do not respect primary care. The RUC does not respect primary care. And Americans as a whole do not respect primary care when someone else pays the bill.
It is just not appealing for patients or doctors to schedule a double or triple-booked office hours day, make patients wait 45min, rush through a 6min visit and scribble a rx or referral for some questionable, perhaps unnecessary medication, test, or consult.
Wake up American patients and primary care docs.
Patient entitlement and undervalued primary care will NEVER get fixed by the current medical-industrial complex.
It’s a fixed pie. For every primary care doc to get paid their true value, there will be a status quo doctor who will lose money. Ain’t happenin.
The bottom line is there is no place for primary care in the current medical-industrial complex. The powerbrokers in the current nonsystem have severed primary care’s spinal cord.
I am more optimistic than ever. A critical mass of brave primary care docs are forming new networks of care based on affordable, quality-driven value. It won’t take long for patients and doctors both to realize there is a better way to practice primary care advanced general medicine.

By: Opinion: How the patient-centered medical home can improve our health care system « The ACUTE CARE Blog: Non-Urban Emergency Medicine

Sat, 17 Oct 2009 17:07:42 +0000

[...] Opinion: How the patient-centered medical home can improve our health care system Posted on October 17, 2009 by coptermedic A guest post by David Harlow on KevinMD: [...]

By: Diane J Standiford

Diane J Standiford — Sat, 17 Oct 2009 15:00:02 +0000

This sounds quite wonderful. This is change I can get behind. As a chronic need patient, who is stable and basically needs refills (I have secondary MS 20 yrs in from DX)—the money saved would be in the thousands. Just for ME!

By: christophil M.D.

christophil M.D. — Sat, 17 Oct 2009 14:07:01 +0000

Primary care is on a vent, PCMH will be the final nail in the coffin. What bright enthusiastic freshly minted medical student would go into primary care and shoulder the burden PCMH lays out and be paid for outcomes in “patient management, comprehensive, relationship-based care”.

Pay primary care doctors fairly for their time and they will achieve stellar outcomes. Otherwise they may go into consulting and dream up elaborate albeit unrealistic models of health care delivery.

By: Tex Bryant

Tex Bryant — Sat, 17 Oct 2009 12:05:52 +0000

I met Dr. Grundy last spring and was very impressed by his dedication to the patient-centered medical home. Although many of the tools necessary to successfully implement the PCMH concept are technological, the success of the model rests on a new relationship between patient and physician. As physicians help patients manage chronic conditions or avoid potential chronic conditions, the new relationship encourages the patient to become more involved in the decision making process as well as become more responsible. Becoming a more active partner in his/her own care, the patient is more likely to succeed. Many of the ideas in the PCMH are highly correlated to the IOM’s prescriptive recommendations found in “Crossing the Quality Chasm.”