Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Let consumers decide if they want the patient centered medical home

Jaan Sidorov, MD
Tech
July 29, 2010
Share
Tweet
Share

Is the Patient Centered Medical Home (PCMH) the panacea for all that ails health care?

Have we exhausted all the allegories related to the term “home?” The answer to both questions apparently is no, thanks to this American Journal of Managed Care article by Timothy Hoff titled The Shaky Foundation of the Patient Centered Medical Home.

Dr. Hoff appropriately shelves PCMH policy and looks at the topic with a market-based perspective. From that vantage point, it all boils down to two customers: the primary care physicians and their patients.

Neither are slam dunks.

Primary care physicians: fewer medical school graduates are pursuing generalist careers and, in the meantime, the existing primary care workforce is getting older. Dr. Hoff quotes optimistic estimates of $30,000 to $40,000 per year in extra PCMH income per primary care physician and doubts those sums will be enough to dissuade the freshly minted doctors from pursuing more lucrative specialist careers.

To add insult to injury, primary care is also saddled with 1) a relative absence among U.S. medical school faculty, 2) a lingering second-class “image problem,” 3) chaotic work schedules, 4) novel professional responsibilities (“team leader?”) and 5) the distinct possibility that transforming primary care clinics into PCMHs will require even greater effort and economic sacrifice over the short term. It’s enough to make even the DMCB want to apply to a dermatology residency right now.

Patients: there is an abiding assumption among policy makers that health care consumers pine for the days when they had a personal physician to coordinate their health care needs, tut-tut don’t-worry about that nagging backache and ask how Aunt Bee is doin’. Unfortunately, many of the Boomers, Generation X and the Millenials have grown up with a fragmented health care system and may not mind episodic care as much as has been assumed. No wonder the rise of Retail Care Clinics are such an irritant to many of the health policy mandarins, since their success among persons who treat health care like fast food seem to run counter to our cherished – and possibly mistaken – central-planning style notions of how patients should behave.

Dr. Hoff’s solutions include “socializing” medical students to primary care and recognizing that it may need to create a two track medical home and assembly line model of care.

The Disease Management Care Blog agrees with Dr. Hoff’s analysis but is tempted to go one step further. Ultimately, it thinks, the success of the PCMH could end up being dependent on patient demand and patient dollars. If those two elements are there, the doctors will eventually follow. That may mean that the PCMH will have to adapt to the creative destruction of capitalism. Like it or not, it’s an important force in healthcare, even with the government meddling. If the PCMH doesn’t make it, maybe it’ll be for the right reason: consumers want something else.

If that happens, the DMCB is confident future leader-entrepreneurs in primary care can come up with the answer.

Jaan Sidorov is an internal medicine physician who blogs at the Disease Management Care Blog.

Submit a guest post and be heard.

Prev

Kombucha tea can be dangerous to your health

July 29, 2010 Kevin 6
…
Next

What to do if your doctor quits and leaves medicine

July 29, 2010 Kevin 13
…

Tagged as: Primary Care

Post navigation

< Previous Post
Kombucha tea can be dangerous to your health
Next Post >
What to do if your doctor quits and leaves medicine

ADVERTISEMENT

More by Jaan Sidorov, MD

  • Are clinically integrated networks a cure for checkbox medicine?

    Jaan Sidorov, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Is the doctor of medicine degree vulnerable?

    Jaan Sidorov, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Reasonable and necessary: 2 words Medicare has trouble with

    Jaan Sidorov, MD

More in Tech

  • Why clinicians must lead health care tech innovation

    Kimberly Smith, RN
  • Why medical notes have become billing scripts instead of patient stories

    Sriman Swarup, MD, MBA
  • a desk with keyboard and ipad with the kevinmd logo

    AI in health care is moving too fast for the human heart

    Tiffiny Black, DM, MPA, MBA
  • Why AI in health care needs the same scrutiny as chemotherapy

    Rafael Rolon Rivera, MD
  • The silent cost of choosing personalization over privacy in health care

    Dr. Giriraj Tosh Purohit
  • Why trust and simplicity matter more than buzzwords in hospital AI

    Rafael Rolon Rivera, MD
  • Most Popular

  • Past Week

    • Why palliative care is more than just end-of-life support

      Dr. Vishal Parackal | Conditions
    • When life makes you depend on Depends

      Francisco M. Torres, MD | Physician
    • Guilty until proven innocent? My experience with a state medical board.

      Jeffrey Hatef, Jr., MD | Physician
    • Why medical notes have become billing scripts instead of patient stories

      Sriman Swarup, MD, MBA | Tech
    • How denial of hypertension endangers lives and what doctors can do

      Dr. Aminat O. Akintola | Conditions
    • A powerful story of addiction, strength, and redemption

      Ryan McCarthy, MD | Physician
  • Past 6 Months

    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why doctors should rethink investing compared to the average U.S. investor [PODCAST]

      The Podcast by KevinMD | Podcast
    • How chronic stress harms the heart in minority communities

      Monzur Morshed, MD and Kaysan Morshed | Conditions
    • Could antibiotics beat heart disease where statins failed?

      Larry Kaskel, MD | Conditions
    • The dying man who gave me flowers changed how I see care

      Augusta Uwah, MD | Physician
    • Universities must tap endowments to sustain biomedical research

      Adeel Khan, MD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 4 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why palliative care is more than just end-of-life support

      Dr. Vishal Parackal | Conditions
    • When life makes you depend on Depends

      Francisco M. Torres, MD | Physician
    • Guilty until proven innocent? My experience with a state medical board.

      Jeffrey Hatef, Jr., MD | Physician
    • Why medical notes have become billing scripts instead of patient stories

      Sriman Swarup, MD, MBA | Tech
    • How denial of hypertension endangers lives and what doctors can do

      Dr. Aminat O. Akintola | Conditions
    • A powerful story of addiction, strength, and redemption

      Ryan McCarthy, MD | Physician
  • Past 6 Months

    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why doctors should rethink investing compared to the average U.S. investor [PODCAST]

      The Podcast by KevinMD | Podcast
    • How chronic stress harms the heart in minority communities

      Monzur Morshed, MD and Kaysan Morshed | Conditions
    • Could antibiotics beat heart disease where statins failed?

      Larry Kaskel, MD | Conditions
    • The dying man who gave me flowers changed how I see care

      Augusta Uwah, MD | Physician
    • Universities must tap endowments to sustain biomedical research

      Adeel Khan, MD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Let consumers decide if they want the patient centered medical home
4 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...