New Orleans grows into testing ground for medical homes

Physician leaders believe that lessons learned there may be used to establish the primary care model elsewhere.

By Damon Adams, AMNews staff. Sept. 24, 2007.

In the low-income Treme neighborhood of New Orleans, Anjali Niyogi, MD, makes her patients feel at home.

Three days a week, the internist treats area residents who come to the Tulane University Community Health Center at Covenant House, a clinic that has become a refuge for the uninsured and underserved.

"For a lot of patients who live in the neighborhood, we are the first stop for them. They get to know the doctors. They feel comfortable that they can call them at any point. It makes for easier physician-patient relations," she said.

The Tulane center is among more than 20 clinics in greater New Orleans reshaping primary care by introducing a medical home concept in neighborhood clinics that serve as havens for the needy. Charity Hospital once provided medical care to indigent patients with nowhere else to turn, but the facility closed when Hurricane Katrina walloped the region on Aug. 29, 2005.

Many medical leaders working to establish the new way of giving care said medical home settings will provide better coordinated primary care with specialist referrals and electronic medical records. And they believe this model of care is one solution to emergency department crowding fueled by patients who used Charity Hospital's ED for primary and other non-emergency care.

Physician organizations promoting medical homes in private practices nationwide are watching to see what happens. If the initiative succeeds in New Orleans, the model may be adopted more readily in other cities across the nation, experts said.