A "Medical Home"

The Commonwealth Fund 2006 Health Care Quality Survey reports something we've known and seen for a number of years here at Central Dallas Ministries.

Patients who enjoy the services of a "medical home" do much better than those patients who rely upon other sorts of medical providers for their care. By "medical home" we mean a health care setting where patients receive "timely, well-organized care," including routine preventive screenings, and management of chronic conditions. You know, the kind of doctor's office most of us grew up with!

When patients have access to such a medical setting, guess what happens? They are cared for appropriately!

What is most encouraging is the fact that racial and ethnic disparities in access and quality are dramatically reduced and even eliminated in such settings. The report documents the fact that when minority patients have a "medical home," they get the care they need. In fact, the numbers are the same for white, black and Hispanic patients.

Here's another finding that will likely cause you to say or think, "Duh!" Patients who receive patient reminders for check ups report an increase in screenings for cholesterol, breast cancer, and prostate cancer. In the context of a "medical home," minority patients are just as likely as white patients to receive these reminders, which drive up the number of patients receiving routine, preventive screenings. Patients who lack health insurance, but who have a "medical home," receive preventive care reminders at the same rate as the fully insured.

Forty-three percent of Latino patients report that they have no regular doctor or setting for care. A little over one in five African Americans have no "medical home."

Patients who have a "medical home" are able to manage their chronic conditions better than those who do not have such a health care venue. Patients who use public health facilities are less likely to encounter a "medical home" environment in those settings--only 21% of these patients reported receiving care in such venues that would qualify them as a "medical home."

Only 27% of all Americans (ages 18 to 64) report having all four indicators of a "medical home"--a regular doctor or source of care; no difficulty contacting a provider by phone; no difficulty getting care or advice after office hours or on weekends; and doctor's visits that are well-organized and running on time.

Not surprisingly, the uninsured are the least likely to enjoy the benefits of a "medical home"--only 16%, while 45% do not have even a regular source of care.

The report makes it clear that all health care providers should take steps to turn existing points of care into legitimate "medical homes" for their patients.

Over the past ten years we have been taking steps to create a "medical home" for everyone who comes seeking care from our Community Health Services division of CDM. We are most grateful for the leadership of Dr. Jim Walton, Chief Health Equity Officer for the Baylor Health Care System and for the partnership we enjoy with Baylor and with Health Texas Provider Network, the physicians' group supporting the Baylor system.

Our efforts at CHS are designed to provide consistent, efficient, high-touch care for everyone who comes to our community practice. As a result, we have transitioned from a "walk-in," M.A.S.H.-type medical unit to a family practice, appointment clinic, complete with health screenings, a full-service pharmacy and doctors who know and care for their patients. On top of this, Dr. Walton even makes routine, weekly house calls!

Reading research that confirms our operating philosophy is encouraging.

Our patients are very "poor" in terms of their economic status. To our medical team they are cherished friends who deserve the very best of care.