NORTH BAY BUSINESS JOURNAL EVENT

2008 Going Green Conference: Building, Technology & Practices

Thursday, October 9, 2008, 7:30-11:45 a.m., Doubletree Hotel, Rohnert Park

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Brad Bollinger: In health care, there’s no place like a medical home

There is a new phrase being used with increasing frequency in health care: a medical home.

The concept is simple: a primary care doctor for everyone, who serves as the first stop for basic and preventative care.

The term medical home originated in 1967 aimed principally at assuring children had access to a physician.

In 2007, the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians and the American Osteopathic Association expanded on the concept with the release of a set of joint principles around the “patient-centered medical home.”

No. 1 on the list of principles: a personal physician with which “each patient has an ongoing relationship” and who is “trained to provide first contact, continuous and comprehensive care.”

For insured residents in the North Bay, the medical home is their personal physician. For thousands of others who are uninsured or underinsured, their medical home is one of a dozen or more health centers around the North Bay.

But thousands remain without that first line of contact.

Lacking a regular doctor, children and adults are unlikely to receive routine checkups. Common preventative care is absent. Minor problems can become chronic conditions, such as diabetes. If a chronic disease is present, it often is not properly managed. And, finally, lacking a place to go, the emergency room often becomes the de facto – and very costly – doctor’s office.

Much is being done throughout the North Bay to bring the medical home concept to reality. For instance, Kaiser Permanente, Sutter Health and St. Joseph’s Health System are helping extend insurance to thousands of North Bay children.

Of course, a medial home will not solve all of the problems in the medical delivery system. Many analysts say the current medical payments system is biased toward procedures rather than less costly prevention. Costs are continuing to spiral, which, coincidentally, is one area a medical home can help.

A 2004 study entitled a “New Model of Family Medicine” estimated that a medical home for every American would reduce costs by 5.6 percent, or $67 billion a year.

And, by the way, the study found the quality of patient care would actually increase.

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Brad Bollinger is editor in chief and associate publisher of the Business Journal.