Disparities in care still undercut quality progress

Increasing trust and building a "medical home" are proposed fixes to quality and disparity problems.

By Andis Robeznieks, AMNews staff. Jan. 19, 2004.

Tony Hampton, MD, urges patients at Circle Family Care's clinic on Chicago's West Side to "be a statistical abnormality." He wants them to be in that minority of minority patients who stay on their medications, lose weight and quit smoking.

In fact, Dr. Hampton, a family physician, has made a special effort to reverse health care trends involving low-income and minority patients. He is trying to reduce their use of hospital emergency departments and increase delivery of preventive care.

These are just two issues documented in a pair of recently released government reports about the quality of and disparities in the nation's health care system.

The reports say quality health care is not universal and that differences exist along economic, racial, ethnic and geographic lines; that chances to provide preventive care are often missed; and that there is much to learn but progress is possible.

Some experts contend that the only way to address the deficiencies is to reform the health care system.

"These are symptoms that we have a system that doesn't work," said American Academy of Family Physicians President Michael Fleming, MD. "The answer is health system change, because I don't think there is an answer in the way the health system is currently configured."

The AAFP is working toward building a health care system using a primary care-based model. Dr. Fleming said such a system would reduce disparities by providing a "medical home" to people who now see a different physician each time they enter the health care system. "They receive episodic and urgent care rather than continual and coordinated care," said Dr. Fleming, of Shreveport, La.