"Medical Home" - better coordinated care, cost effective, but some problems.
One thing that has not been addressed by the current healthcare debate is how to keep family physicians in practice and to find a way to encourage more individuals to go into family practice. There must be a more reasonable payment made to physicians for office visits to coordinate care. When we talk about cutting costs in Medicare and Insurance, it always seems that the answer is in paying doctors less than their costs of doing business. Therefore, they are forced to see too many patients, work too many hours to make reasonable compensation and have a life outside of their practice.
I have recently realized that I have been operating as if I was utilizing the Medical Home concept of healthcare. I have been fortunate to have an excellent family physician and 3 specialists, when needed. The last few months I have had various procedures and tests with specialty doctors and I make sure that any lab work and reports are sent to all of the doctors to eliminate duplicate tests and to coordinate their efforts. I have a few idiosyncrasies in my blood work that could indicate serious problems, but have had these for over 20 years and any possible diseases relating to those abnormal results have been eliminated (except for the 50% increase for my insurance premiums). Without the continuity of physicians and consulting with my doctor, every visit to a new doctor would result in unnecessary, oh my God moments, blood tests and procedures when they see "my normal" results.
If we go to a Medical Home concept of medicine, there are a few areas which we all need to address.
It is imperative for each person to be able to control which doctor would be their primary physician and to maintain that continuity as much as possible. We must move away from procedure driven payments to quality care from physicians and compensate doctors for office visits accordingly. We can no longer talk about just paying less as a way to control rising healthcare costs. The Medical Home concept, if used correctly, would allow us to pay more for some services while saving much more in overall costs with a better patient care and outcome. The return on investment as savings would be much greater than any costs.
This must be a part of the real solution, but will also require patient responsibility and everyone to have insurance. But those issues are for my next posts.
TVP tvp@dyingforinsurance.com
Posted by The Virtual Patient at 10/16/2009 5:11 PM 
Categories: doctors, Costs, Patient Responsibility
Tags: Patient doctors health care costs
Categories: doctors, Costs, Patient Responsibility
Tags: Patient doctors health care costs
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