You may be hearing this phrase quite often these days,
particularly when Patient Centered Medical or Health Homes are the
topic. So what is this latest greatest idea that is supposed to
improve care, improve health and decrease the cost of health care (also called
the IHI Triple Aim
or the Three Part Aim)?
Well, today let’s take a look at what we’ll call Traditional
Medical Care. You know the kind. Looks something like the graphic below. The
doctor is the sole person responsible for all the care the patient gets. She/He
is responsible for answering all the questions, calls, letters, requests. He/She
is responsible for completing all the refills, referrals, education visits.
She/He is responsible for managing all the preventive care, chronic care, acute
care. She/He is responsible for everything. Oh yeah, they may have some help
from a Medical Assistant, a nurse, or a front office person, but everything must
go through the provider first.
And to get that care, the patient must come to the doctor’s
office. If the patient receives care in a multi-provider office or clinic, they
might see whichever doctor was available that day, someone the patient may or
may not already know. Lastly, the care that patient receives is based on the
decisions of the doctor that day (who may or may not ask the patient their
opinion). And for questions, med refills, follow up on tests, or other info
outside of that office visit? With the Traditional Medical Care model, as you
can imagine (or have experienced) there are many challenges to meeting these
demands. If a typical provider were to do everything that is recommended for
preventive and chronic care for the patients they are responsible for, they
would have to work 18 hours every day
! And this does not include addressing urgent needs the patient may
have. This is obviously not humanly possible.
Tomorrow we’ll take a look at what Team Based Care is and why
it can help address these very challenging issues.