Board Adopts Policy on Personal Medical Home

The 2004 Future of Family Medicine report called for changes in the U.S. health care system, such as "taking steps to ensure that every American has a personal medical home," and now the AAFP Board of Directors has adopted a policy that includes a definition of "personal medical home," according to Board Chair Mary Frank, M.D., of Mill Valley, Calif.

"This statement will give guidance to family physicians who want their offices to be considered their patients' medical home, and the policy will help family physicians be on the same page when they say 'personal medical home,'" says Frank.

The Future of Family Medicine report credits the American Academy of Pediatrics with introducing the phrase "medical home," and AAFP's statement builds on a description in the FFM report. The new policy says, "The American Academy of Family Physicians believes that everyone should have a personal medical home that serves as the focal point through which all individuals -- regardless of age, sex, race or socioeconomic status -- receive acute, chronic and preventive medical services. Through ongoing relationship with a family physician in their medical home, patients can be assured of care that is not only accessible but also accountable, comprehensive, integrated, patient-centered, safe, scientifically valid, and satisfying to both patients and their physicians."

The Board adopted the statement, recommended by a subcommittee of Board members, during the Board's May 2-4 meeting in Leawood, Kan., and Kansas City, Mo. "It's not a big stretch to say the family medicine office could be the ideal personal medical home because we do acute, chronic and preventive care for patients of all ages," said Frank. "Family medicine offices that patients consider their personal medical home should be able to provide patients with the services they need or help them get the services if they're not available in the office."

For example, said Frank, she referred a 67-year-old man to a cardiologist because he kept "going in and out of atrial flutter." The cardiologist changed the patient's medicines, but then the patient came back to Frank to discuss his medicines, why he had to take them, how long he had to take them and what the next step might be.

"He has a lot of anxiety," said Frank. "When his anxiety gets worse, it makes his cardiac symptoms worse. In addition to talking about his heart, we talked about his fears and how he might manage the anxiety." She also suggested that he ask the cardiologist whether he could receive two of his medicines in a combined form. "I was able to advise him about a way to make his life a little simpler," said Frank.

"Patients who come to their family physician's office, to their personal medical home, should be able to receive the best care a family physician can provide, as well as to discuss the care they receive from other physicians and to sort through the choices they might have about treatment," said Frank.