Model of Care
Several years ago, the Future of Family Medicine (FFM) project was undertaken by the AAFP and other family medicine organizations to determine what patients want and need from the health care system – and what role family physicians play. In 2004, recommendations were made to create a “new model of care” in which family medicine would redesign the work and workplaces of family physicians to better care for patients and communities.
The family medicine model of care aims to reintegrate and personalize health care for patients, who are increasingly frustrated with the fragmented and complex health care system. It is a deviation from traditional models of care, including specialist care, in that it is patient-centered versus physician-centered. The Affordable Care Act aligns with this model of care and aims to put primary care at the forefront of the health care landscape through implementation of measures that:
- Increase patient access to health care insurance coverage,
- Incentivize preventive health care and align health care provider payments with patient health outcomes, and
- Increase the primary care physician workforce.
The family medicine model provides patients with a personal medical home through which they receive a full range of services within the context of a continuing relationship with their family physician. Family physicians deliver acute, chronic, and preventive care, either directly or indirectly through established relationships with clinicians outside their practice. The U.S. Department of Health and Human Services refers to primary care physicians as gatekeepers to the health care system, and family physicians are well suited for this important role. Unlike other specialties that are limited to a particular organ, disease, age, or sex, family medicine integrates care for male and female patients of all ages within the context of community and advocates for the patient in an increasingly complex health care system. In other words, family physicians are dedicated to treating the whole person. They not only hold the metaphorical keys to providers across the health care system, but they shepherd patients through the complex system and through coordinated care of their health. By building relationships with their patients over time, family physicians develop a comprehensive understanding of their patients’ health.
Implementation of the family medicine model of care includes:
- Using a team approach to care.
- Reducing barriers to care by such means as open access scheduling, expanded office hours and improved communication between office staff and patients.
- Implementing advanced informational systems, including the integration of electronic health records (EHRs).
- Putting an emphasis on quality and safety.
- Providing care in the context of the individual and the community.
There is growing support for the medical home as evidenced by the endorsement of this concept by a number of organizations, including the Association of American Medical Colleges(www.aamc.org), and the formation of the Patient-Centered Primary Care Collaborative(www.pcpcc.net).
The patient-centered medical home (PCMH) model of care provides greater satisfaction to patients, physicians, and the health care team by ensuring that patients' needs are met and access to care is improved, health information is handled effectively, and the team works as a cohesive unit.
Benefits of Implementing a Primary Care Patient-Centered Medical Home(www.pcpcc.net) details results from 24 peer-reviewed and industry reports. It demonstrates that the patient-centered medical home (PCMH) model improves health outcomes, enhances the patient and provider experience of care, and reduces expensive, unnecessary hospital and emergency department utilization. In addition, the report provides information on 23 case studies outlining specific features of a PCMH. This report was released in 2012 by the Patient-Centered Primary Care Collaborative (PCPCC).
PCPCC estimates that $700 billion of the $2.5 trillion in annual health care spending in the U.S. is unnecessary. Efforts to transform primary care via PCMH have gained tremendous momentum in recent years, making this model important for medical students interested in any specialty to learn.
The AAFP and the STFM Group on Medical Student Education have designed a presentation for medical students that explains the PCMH and its importance to family physicians. This PowerPoint presentation is below and is accompanied by a document with suggested speakers' notes that can help in presenting this information. Family medicine faculty are encouraged to give this presentation to medical students, FMIG groups, and others.
Also, the AAFP has created a short video about PCMH(www.youtube.com).
PCMH Flyer for Medical Students(2 page PDF) -- This front-and-back flyer was developed specifically for the medical student audience. It includes facts about the PCMH and questions about PCMH students should ask residency programs during the interview process.
Joy in Practice -- Patient-centered medical home innovations can free physicians and clinicians from administrative duties, put them more in control of their work environment, and better organize their work. Find out more about how family physicians are rediscovering joy in practice.
The AAFP welcomes and appreciates your comments about the PCMH presentation. Please send us an email. We'd love to hear how you are using the presentation and your ideas for how it could be improved.