Healing Healthcare: The Patient-Centered Medical Home

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    Dr. Keith Holmes is an Ochsner Internal Medicine physician and a Central resident who practices at Ochsner Health Center – Central.   This is the first in a series of articles discussing the future of healthcare and the Patient Centered Medical Home.
    The Future of Healthcare: Whether you agree or disagree with the Affordable Care Act, one thing is certain about the delivery of healthcare in the United States – the current system is financially unsustainable.  America spends a much larger percentage of its gross domestic product on healthcare than any other country and our outcomes (as measured by the quality of care delivered) are not better and in many ways underperform other developed countries.  We have the best tertiary care (e.g. transplants and other highly technical levels of care) in the world but the majority of us will never need that level of care.  Where America falls short is being able to deliver primary and secondary level care at an affordable rate.  
    For the last 30 years the cost of delivering healthcare has been increasing 2-4 times the average rate of inflation and now consumes about 16% of every dollar spent.  Unless things are changed, that rate will only increase as the flood of baby boomers reach their senior years.  According to the Pew Research Center an additional 10,000 people celebrate their 65th birthday every day.  This is expected to continue for the next 18 years until the last baby boomer turns 65.  With the avalanche of associated healthcare expenses, paying for healthcare is going to become an even larger problem, impacting us all.  
    Patient Centered Medical Home: We have to deliver better care for fewer dollars.  In the current system, patients tend to go to their cardiologist for high blood pressure, to their endocrinologist for diabetes, to their neurologist for migraines, to their pulmonologist for emphysema, to their gynecologist for a pap smear, to their orthopedist for knee pain, and the list goes on.  In reality, a primary care physician can handle the vast majority of these needs.  
    We, as primary care physicians, are long-term partners with our patients.  This partnership is based on trust that develops over time as our patients become more and more confident that we have their best interest at heart.  As a result, when you need to see a specialist, you get better care if you first seek the advice of your primary care physician and let him/her advise you on the next steps in your care.  
    Building a relationship of trust between the patient and their primary care physician is what a Patient Centered Medical Home model of care is all about.  The Patient Centered Medical Home model uses a team approach that focuses on each patient’s individual needs.  Part of that need is directing or managing care.  When the primary care physician manages a patient’s overall care that patient sees benefits such as no duplication of tests, reduced costs and better health outcomes. These benefits have already been shown in areas of the country that have implemented this model.  In these communities, quality measure scores improved, ER visits went down and hospital stays were reduced.  This translates into better care for fewer dollars and is good news for everyone.  
    At Ochsner, we are dedicated to being a part of the long-term healthcare solution.  We have made a commitment to establishing these Patient Centered Medical Home models of care at all of our primary care locations, including Ochsner Health Center – Central.  Dr. Keith Holmes can be contacted at 261-9790.