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.