Societies set principles for medical home

Patients would play an active role in decision-making and provide feedback on their care under the new plan.

By Damon Adams, amednews staff. April 9, 2007.

Four physician organizations have released joint principles of the patient-centered medical home, a primary care approach that features a personal physician, coordinated care and enhanced access for patients.

The seven principles were issued last month by the American College of Physicians, American Academy of Family Physicians, American Academy of Pediatrics and American Osteopathic Assn. Together, the societies represent 333,000 physicians.

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"This says, 'This is what we're after.' We know this is what works for cost-efficient quality care," said Ashland, Ky., family physician Larry S. Fields, MD, AAFP board chair.

In 2002, the AAP expanded its medical home concept, officials said. The AAFP developed a model in 2004, and the ACP followed with its advanced medical home in 2006.

Building on that foundation, the four organizations agreed on seven principles they said should make up a medical home:

Personal physician who provides first contact and continuous care.
Physician-directed practice, in which the personal doctor leads a team at the practice level.
Whole-person orientation, with the physician providing or arranging for care for all stages of life, including end-of-life care.
Coordinated care across the health system.
Quality and safety, with evidence-based medicine guiding decision-making and utilization of information technology.
Enhanced access to care through systems such as open scheduling and expanded hours.
Payment that recognizes the value of a patient-centered medical home.

"It's an opportunity for physicians to look at this and look at their practice and provide the type of care we want for the patient," said Dayton, Ohio, family physician Paul A. Martin, DO, a member of the AOA's joint committee on quality and reimbursement. "It also engages the patient in their own care so they can dialogue with the physician and become an active participant in their care."

Dr. Fields said: "We can now move forward with lobbying Capitol Hill and talking to businesses about the medical home and what it is."

The doctors are in the house
The AMA's House of Delegates is holding its Interim Meeting Nov. 7-10 in Houston, addressing issues such as health system reform and physician payment.
AMA House - Slideshow - Updates