Innovation
4:22 pm
Mon April 1, 2013

Medical Homes House Multiple Services Under One Roof

Asaf Bitton
Asaf Bitton
Credit WGBH

A visit to your primary care physician often means long waits in exchange for fleeting face-time with your doctor. But a growing trend in the medical field aims to change that – and a whole lot more – about the way patients are treated.

Come in for a routine check-up at Advanced Primary Care Associates in Jamaica Plain, and you may end up sitting down with a pharmacist. This isn’t your typical doctor’s office. It’s what’s known as a patient-centered medical home.

"So a medical home is essentially a clinic in which there’s a team of providers in different levels of health professions who work together centered around a patient’s needs to provide health care and health promotion," said Asaf Bitton, a primary care physician and assistant medical director at APCA.

Bitton is part of team that includes a physician’s assistant, a social worker, a pharmacist, and a nutrition expert. Before their daily appointments, the team “huddles” to discuss each patient’s care.

"We think that by having various professionals who are coordinating, who are accessible 24/7 who work together and ask you what your needs are – we think that’s getting closer to what patients actually want," Bitton said.

Part of that coordination includes what’s called a “warm hand-off” – from one specialist to another.

"A primary care doctor or physician’s assistant might be with a patient and something comes up," clinical social worker Sarah Gale explained. "It could be, for example, an issue of domestic violence. I’m not scheduled the whole day, so I can be pulled in at a moment’s notice and we can start the intervention right away."

There’s no pharmacy in the practice – but full-time pharmacist Sonia Freitas is on hand to help patients manage their meds.

"I educate patients on the correct and safe use of the medications that they’ve been prescribed," Gale said. "I really think that if patients know better why they’re taking their medications, they’re more apt to take them, and they’re also more apt to communicate with us when they’re not taking them."

Maria Cuellar made the switch from a traditional primary care practice to the medical home a year and a half ago. She says the personal attention and coordinated care she receives makes a huge difference.

"You know I have diabetes, I have other medical issues, and they’ve always kept up with me," Cuellar said. "They don’t make just you feel like you’re just a patient. They actually make you feel like a person."

The medical home model is relatively new, so its track record is unproven – but Bitton says he sees the benefits in both care and cost.

"The early studies of this model show that it looks like it improves patient quality and improve patient’s experience of their health care," Bitton said. "And from a systems point of view, because health care is so expensive, it looks like it may be starting to lower overall health costs."

Meredith Rosenthal, professor of health economics at Harvard School of Public Health, predicts the team approach to care will soon become commonplace.

"Nationally, patient-centered medical homes, I would say, have really taken off," Rosenthal said. "You may not have a medical yet. I would say in the Commonwealth in particular there are many medical homes under construction coming to a corner near you."

Better quality at lower cost. That’s a prognosis we can all live with.