Primary Care Medical Home: Will it Work?

In my post last week, I discussed the concept of the Primary Care Medical Home (PCMH), an effort to revamp the primary care system proposed by the Affordable Care Act.  As with any reform effort, the question is "Will it work"?.

In researching the PCMH, I was slightly confused.  Shouldn't medical practices already attempt to reduce wait times?  Don't most primary care practices offer walk-in hours for patient who come down with cases of fevers and flus?  Since when has advocating safety and quality in medical care been a novel idea?

The concepts of comprehensive, patient-centered, coordinated care are not new or novel.  In fact, they are simply common sense.  Although many wish it was not, a medical practice is a business.  Smart physicians and office managers should naturally make efforts to accommodate as many patients as possible attempting to utilize their time and resources effectively.  In an effort to provide customer service, they should foster relationships with specialists offering streamlined access to specialized care.  As for the idea of members of a medical practice working as a team?  I think most of us recognize the need for health care employees to work together to create the best patient experience possible.  Health care providers are smart people.  They don't need a government initiative to advocate for basic business practices.

I'll be the first to acknowledge that although these concepts are intuitive, many primary care providers owning medical practices are not implementing them into their practices.  Many providers are simply too busy to coordinate improved customer experiences with their staff or to notice issues limiting access to care for their patients.  Others are simply better providers than business people.  They choose to focus solely on medicine rather than running a successful company.

The Primary Care Medical Home concept attempts to address these issues inadequately.  Raising awareness and providing funding for "patient-centered care" (what other kind of care is there?) will not revolutionize the primary care system.  It does not address the root issues of the primary care problem.

As a nurse practitioner, I think it is time to get back to the basics.  Let's not muddy the primary care waters further by involving government guidelines and funding to solve basic problems.  Instead, we must take pride in our practices and be vigilant in providing quality care for our patients.  We will be rewarded in our efforts towards improving patient experiences by a growing practice.