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Posts Tagged ‘Medical home’

Treat Patients the way you would like to get treated

In Health, Healthcare, Medicine on June 2, 2012 at 8:00 am

I  was a happy man when I passed my USMLE Step 3 exam. All doctors in US have to pass the USMLE Step 3 exam which deals with how you ‘Treat’ the patient. It is not just the medical diagnosis and treatment, it is the whole process of management that starts as soon as you enter the room. Doctors get graded heavily on their behavior towards the patient.

With changing healthcare and pressure of documenting everything, doctors are finding it really hard to keep that connection going. 15 minutes for a patient’s visit is not enough most of the times. If you increase the times, the ‘bottom-line revenue gets hurt. It has come to the point where doctors are taking their work home,making it hard for them to enjoy family time. That is why, medicine is no more one of the top demanded profession.

Despite all the hassles and pains, doctors in US continue to treat their patients in the best way they can. What is patient’s need? That somebody listens to them and help them. When listening, analyzing and actions become time-bound, the connection gets lost somewhere leaving both the parties unsatisfied most of the times. We are not paying much ‘Attention’. The doctor-patient relationship is central to the practice of healthcare and is essential for the delivery of high-quality health care in the diagnosis and treatment of disease. The doctor-patient relationship forms one of the foundations of contemporary medical ethics. There are very few physician practices who are actively involved in patient satisfaction surveys to know exactly where they are in terms of their services.

This loss of connection is nobody’s fault. It is the fault of the system that we as a society have designed. Health is no more a personal issue. It has become ‘E-Health’ (electronic health). Now you go for a doctor’s visit, what you hear is clicking(mouse and keyboard). We have lost the personal touch.

Is there a way to revive back the relationship and improve quality on top? Yes. The emerging concept of Patient Centered Medical Home(PCMH) takes away that burden off from the physicians and satisfies the patients. It is a multi-disciplinary integrative  approach towards patient. It does not just deals with the current problems, but helps manage overall wellness. It ensures that patients get the attention required to manage their issues.

PCMH aims to collaborate the various divisions of healthcare on a single platform to give a ‘One Stop Shop’ for health and wellness. AHA, HITECH,ACO and all other reforms added recently, have led Healthcare institutions to come up with processes to reduce waste, improve quality and deliver best possible care. The Healthcare IT industry is the busiest industry in current times. New softwares and techniques are being launched on a daily basis to make the current systems efficient.

But, whatever the case may be, Medicine is about ‘Connecting with the Patient’. We need to focus on E-Health, but not at the stake of Physician-Patient relationship. Whenever I feel myself swaying away by the winds of technological pressures, I stop and think to myself, “Is this the way I would like to be treated if I am a patient?”

From a doctor’s perspective, I would appeal to all the patients that the behavior of  doctors towards health is not by personal choice. The changes in Healthcare are coming too fast and sometimes it is hard to keep holding the ground for the healthcare providers. I am not sure how long this may take. But one thing is for sure, E-health can never overpower the strength of ‘Physician-Patient Relationship’.

Patient Centered Medical Home: Patients equally responsible as Providers

In Health, Healthcare, Medicine on May 19, 2012 at 8:15 pm


The patient‐centered medical home is a model for care provided by physician practices that seeks to strengthen the physician‐patient relationship by replacing episodic care based on illnesses and patient complaints with coordinated care and a long‐term healing relationship. Each patient has an ongoing relationship with a personal physician who leads a team that takes collective responsibility for patient care. The physician‐led care team is responsible for providing all the patient’s health care needs and, when needed, arranges for appropriate care with other qualified physicians. A medical home also emphasizes enhanced care through open scheduling, expanded hours and communication between patients, physicians and staff.

Based on emerging research, the medical home model has the potential to improve health outcomes and reduce overall costs. One way to fix the problem of spiraling health care costs is to try to change the health care system. It isn’t easy. It means completely changing the way everyone does business. But we can’t keep doing what we’re doing because things will just keep getting worse.

The problem is the way the health care system pays for care. It’s called a fee-for-service business model, and it hasn’t changed much since the start of modern health care. Under this model, doctors, hospitals, and other providers are paid for every service they provide – every visit, every test, and procedure they do – whether or not these things improve our health. It’s based on quantity instead of quality.

It can lead to unneeded tests, screenings, and other expensive care that adds to health care costs each year, without making people healthier and, in some cases, making them even less healthy. And it often results in doctors not having enough time to give the care they want to give. According to a recent study, a primary care provider (PCP) would need more than 22 hours a day to finish all of the work expected of them, whether giving care or doing paperwork.

To try to fix this system, insurers, hospitals, doctors, the government, and professional and trade groups are working together to change the way health care works. The major part of that effort is moving from the fee-for-service model to a new patient-centered medical home model. It’s kind of a weird name, but if you think about what it’s trying to do, it makes sense.

A patient-centered medical home, or PCMH, is not a physical building. It’s a way to care for patients so that you feel “at home” with your care. PCMH changes the emphasis from quantity to quality, helping everyone be healthier and reduce the need for costly care.

It’s been proven that when people have a long history with their PCP, they are healthier and have lower health care costs. Kind of makes sense, right? The better your doctor knows you and is aware of factors that might affect your health, such as stress, the more likely it is that diseases can be prevented or caught early, when treating them costs less and before they cause big problems. And as a bonus, when you have a good relationship with your doctor, you’re usually better informed about your health and lead a healthier lifestyle. It’s easier for a doctor who knows you well to effectively nag you!

A key goal of PCMH is to improve the relationship between you and your doctor. A big part of that is giving doctors the time they need to give that familiar level of care. So PCMH helps PCPs change their practices. They are put in charge of teams of providers customized to meet your unique health needs – so if you have a chronic condition, health care “extenders” with expertise in treating your condition could be on your team. The team may also include staff members and health and wellness organizations that offer education, screenings, and other support.

The PCMH system supports these teams with information and a new way to pay for care. Using the latest technology, like electronic health records, makes the team more efficient and improves communication. New detailed reports of patient histories help the team identify patients who need screenings, follow-up visits, and immunizations. That means your doctor and your whole team will have more information to better help you. It will also increase the coordination between different providers on your team. And instead of getting paid for every service they provide, providers are rewarded for making sure you get the right care you need when you need it. It’s about paying for quality.

HMSA members who have a primary care provider and a patient-centered medical home get recommended health screenings and immunizations at a higher rate than those without a PCP and PCMH.

But it’s not all up to the team. As the name implies, PCMH puts you at the center of your care, encouraging you to take an active role in improving and maintaining your health. After all, a team of doctors can only make recommendations. You are the only one who can make yourself exercise, eat right, get your recommended screenings and tests, take your medications as prescribed, and do what you need to do to manage any chronic conditions you have.

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