The practice of primary care pediatrics has improved in many ways over the years, but the most important improvement for the health and well-being of our young patients is the concept of providing care within a medical home. Children who receive their primary care from a medical home are healthier. A medical home is the kind of primary health care we all want and deserve.
First created to help manage the care of children with special health care needs, a medical home is a better way for all children to receive their care. A medical home is an approach to providing comprehensive and high quality primary care. A medical home should be the following:
• Accessible: Family and child easily access care, including that insurance or geography do not limit access.
• Family-centered: There is recognition that the family is the primary caregiver and support for the child, and all medical decisions are made in true partnership with the family.
• Continuous: The same primary care clinician cares for the child from infancy through young adulthood, providing assistance and support to transition to adult care.
• Comprehensive: Preventive, primary and specialty care are coordinated and provided to the child and family.
• Coordinated: A care plan is created in partnership with the family and shared with all health care clinicians and necessary community agencies and organizations.
• Compassionate: Genuine concern for the well-being of a child and family are emphasized and addressed.
• Culturally Effective: The family and child’s culture, language, beliefs and traditions are recognized, valued and respected.
A medical home is not a building or place; it extends into the community. A medical home builds partnerships with clinical specialists, families and community resources. The medical home recognizes the family as a constant in a child’s life and emphasizes partnership between health care professionals and families.
The well check is the time for your pediatrician to organize and coordinate your child’s medical home. That is why these visits are so important. Having a low-cost physical exam for sports coordinated by a coach or performed at an urgent care center is not a substitute for this complete evaluation, relationship building and coordination of all health needs.
Over and over, studies show an association between access to and utilization of pediatric medical homes to improved health outcomes for children, increased satisfaction for children and families and decreased cost of care. This was why all health plans were required to cover well visits without co-pay with the Affordable Care Act. This is also why physicians have been so appalled that the recent efforts to repeal and replace the Affordable Care Act include capping Medicaid and reducing the requirements for access to well checks. Reducing access to a medical home is cruel and will not be good for children and their health.
For more information about the medical home, see the American Academy of Pediatrics’ National Center for Medical Home Implementation: www.medicalhomeinfo.org. When Van Halen calls for “Somebody Get Me a Doctor!” let’s hope they get a medical home.
Dr. Danette Glassy, MD, FAAP, is a pediatrician at Mercer Island Pediatrics, providing a medical home for her patients for over 20 years. She is also an active child advocate working to improve the health and well-being of children and their families across the country. In this column she shares information of interest to families and caregivers as their child’s primary advocate. Information is her own view and not medical advice.
