The Concept of "Medical Home" As we get closer to this year’s presidential election, and healthcare reform continues to be a hot issue, you may hear the term "medical home" and wonder what it means and how it affects you. The concept was originally developed in the late 1960s. It described the creation of a hub of care for children with special needs, a central location for the specialized healthcare and services they required. Since then, and as access to coordinated and affordable care has become more difficult, the concept has broadened. Today many primary care physicians (PCPs), including family practitioners, pediatricians, internists and geriatricians, like to describe their practices as the medical home for a patient’s care. When we patients embrace the concept, it means we look to our PCP as our gateway to all our care. If we need a check up, or experience symptoms, we visit our PCP. If she doesn’t offer the extended services we need, she refers us to a specialist who can help. There are many benefits to patients who follow the medical home model. Having one doctor’s practice as a hub, where they know us, our family members and our medical histories, where all our records are kept, is a very personal and individualized approach to care. Over time, we develop a collaborative and trusting relationship with our medical home practitioners. And when we experience unusual symptoms, and need the services of a variety of specialists, our medical home is where we go to get them coordinated. At least that’s how it’s supposed to work. Not all medical homes do. By the definition of "medical home" used by the American Academy of Family Practice, we should also have access to services like same-day appointments, e-mail access, price lists, and counseling services. Even the doctors who believe strongly in the medical home model admit that it’s impossible to provide that level of service with today’s shortage of PCPs and the continually increasing costs of care. That doesn’t mean the basics that do exist aren’t helpful, however. Patients are wise to establish a medical home, whether their doctor uses that term or not. Establishing a relationship in one central place will reap benefits when we find ourselves needing the services that a trusted, long-term medical advisor can provide. TOP | 
