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I Want a Real Medical Home...Not a Dream

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HGTV's most popular show, House Hunters shares the experiences of homebuyers navigating the process of finding their dream home. Viewers go along as they tour homes and sort out their wish list, their budget and the current state of housing markets in communities across the U.S. and around the world. With a mix of reruns and new episodes, it is both sobering and entertaining to see the shows first aired during the real estate 'bubble' years versus the up-to-date shows. Recently, even though a buyer's market is more often the rule, tighter financing requirements from lenders and the economic recession seem to have downsized buyers' big-home fantasies. But regardless of the date or location of the show, the HGTV house hunters usually end up with their top choice and as the shows conclude they have moved in and we see them in the early stages of homeowner bliss.

When I first learned of the primary care medical home model it seemed to offer a great solution to medical homelessness a sort of permanent doctor-patient renter status, where both parties are bouncing around without a foundation, without a community and where a certain uncertainty exists and miscommunications and disorganization prevail. But the more the medical home has evolved to meet the wish lists of various stakeholders, the more it has seemed like a dream home 'the one that HGTV gives away every year but the winners eventually have to sell because no one can afford to actually live there.

In particular, the patient-centered wish list keeps growing. Even those wide-eyed HGTV homebuyers quickly learn they can rarely have it all and stay within their budget. But lately, I have watched medical home standards and measures and meaningful use and health information technology stimulus incentive requirements grow seemingly without bounds'.and I have increasingly lost hope that I will ever find a medical home for me.

So my medical home wish list is growing shorter and more strategic as I wrestle with realities of the rapidly escalating health care cost curve, increasing physician resistance to Washington oversight and manipulation, and I find myself wanting a starter home, not the trading-up, mega-mansion that once seemed so enticing.

I am left with a medical starter home wish list with just two must- have items: I want my primary care physician to use an electronic medical record (EMR) and I want him or her to give me clear information about the basics of how to engage with their practice. I need a simple guide about how and when to seek care, by whom I will be tested and how I get test results and what I can do to make my care more effective and efficient a medical care instruction guide that contains no more and no less than I get with every new dishwasher.

More Blog Posts by Dorothy Jeffress

author bio

Dorothy Jeffress, MBA, MSW, MA, (djeffress@cfah.org) executive director, joined CFAH in March 2008. Prior positions include vice president, Center for Information Therapy, 2005-2008, where she assisted with the IxAction Alliance membership program, the annual Ix Conference and finance/administration for the IxCenter; and as the assistant vice president of Value Based Purchasing for the National Business Coalition on Health (NBCH) from 2003 to 2005, where she directed the eValue8 Request for Information (RFI) program. She also worked with NCQA from 1999 to 2002 where she was the director of constituent relations and a senior health care analyst in HEDIS performance measure development. She has also worked for the Massachusetts Department of Public Health as the director of a CDC/state-funded women's health promotion and chronic disease prevention program. She has managed a TPA for self-funded employee benefit programs and also been a benefit manager for a mid-sized employer. Dorothy has an MBA from Clemson University and an MSW in clinical social work and an MA in theology from Boston College.


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StarLawrence says
April 15, 2010 at 11:06 AM

My daughter's pediatrician had a neat little booklet about when to call and when not to. I have never seen anything like it from any of my doctors. In the last 14 years, since I moved to AZ, I have not had a doctor I thought of as "my doctor." The docs no longer talk to each other or consult on your issues. When you go in the hosp, you suddenly get another stranger as your doctor (hospitalist) at the worst time of all, when you are really really sick. I remember asking, "Do you KNOW my doctor?" and the woman said no. I tried to call my doctor from the bed and they said, "He's busy, but they will take good care of you and come here when you get out." I could go on and on. I even had one doctor tell me he could not call a dermatologist on my behalf because (that doctor) would get mad." I know this is a function of money and time, but things have surely changed. At present, I have no doctors--no specialists--I am pending. When I decide I am sick enough to go, I will find someone or go to urgent care. Ironically, I now have Medicare instead of weird self-insurance things, but not all docs take that even.