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The Patient’s Viewpoint

Consider this: You are feeling sick and feel overweight. You wonder if your thyroid is acting up and want to get it checked out. You call up your primary care doctor and leave a message for scheduling an appointment.

The nurse or assistant sees the message and fixes the appointment. You come on the scheduled date and the doctor goes through the rigors and it turns out you are stressed. By the time you explain why you are stressed, the appointment is over.

Before leaving, the doctor orders a few tests, and some specialist visits to help with the stress. You seek an appointment with a specialist that takes place at a time and location not very convenient for you.

By the end of it, you are frustrated and think about why you took an appointment in the first place.

The Doctor’s Viewpoint

There is flip side. Just like the patients are frustrated, the doctors are equally disappointed in not providing competent care.

They are under pressure to see a specific number for getting their next paycheck, and then some more. The work continues even after seeing the patient.

There is a lot more work to complete – responding to patient’s queries and messages, checking labs, filling out various forms, reviewing and signing further care on necessary patients, completing the chart notes, and finally documenting the visits for billing purposes.

The result - A frustrated patient and an equally frustrated doctor who both curse the system for inefficient or unsatisfactory care.

The solution to it - Patient-Centered Medical Home (PCMH) model. So, what is the PCMH model?

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Patient-Centered Medical Home (PCMH) Model

The PCMH or the Patient-Centered Medical Home model is a care delivery model wherein the primary care doctor coordinates the treatment of a patient.

This is to make sure that the patients receive necessary care at their time and place and in a manner that they can understand.

The primary objective is having a centralized setting, which helps in better coordination between the patient and the personal physician, and also the family, when appropriate.

In the PCMH model, patient care is facilitated by the use of registries, health information exchange, information technology, and other means to ensure that the patients get indicated care at their convenient time and place.

The Origins

Patient-Centered Medical Home model originated with the need to provide specialized care for children with special needs.

The success of this model forced researchers to focus on delivery models where the returns are high while the cost is minimal. Across the country, hospitals and various other organizations are adopting PCMH concepts.

Individual physician groups are implementing the PCMH practices aided by newer payment models, as well as other key drivers.

The Concept

Under PCMH, your primary becomes a member of the multi-disciplinary team that offers comprehensive care under one “roof.”

Moving forward, when a person pays for health insurance, the concerned primary care doctor gets one flat payment to cover for the care provided. The amount is decided depending upon the patient’s medical condition and other complexities.

This will ensure that the concept of billing for every single visit is done away with. Services like nutrition and behavioral health will be offered in the office.

Specific health goals will be determined by both physicians and patients, which can, in turn, result in bonus incentives.

Good practices like helping in losing weight, getting and blood pressure, and blood sugar under control and keeping the patient away from the ER and the hospital will be rewarded.

How Will It Be Done

This will be ensured with proper and more effective use of modern and creative equipment, which help in keeping track of the patient’s progress.

This also will necessitate the hiring of more staff who will help in better coordination between the physician and patient. Doctors also will require to be more accessible and answer that message or call back.

Those hospitals and physician groups who desire to implement this model need to get through a rigorous certification process by an outside agency. There is also oversight to make sure that goals are met.

PCMH keeps the patient at the forefront of care, and patient satisfaction is a huge component.

In Conclusion

PCMH model is a win-win situation for both doctors and patients. The doctor gets timely payments and the patients get better and more satisfactory care.

It has also resulted in better diabetes control, improved medication compliance, as well as decreased hospital visits