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Primary Care: We Can Do Better

To improve the quality of the health care my wife and our family, and you and your family receive, we need to put the focus back on primary care.
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Every year my cat gets a postcard notice from his vet when it's time to get his shots. My wife, however, has to keep her own records of when it's time for her mammography.

I love my cat. I think it's wonderful that he has such a conscientious vet. I love my wife even more and want her to stay healthy too. I would like it if she -- and I -- would get the same degree of care and professionalism as our pet enjoys. After all, we're only human. We need help keeping track of our medical histories. I think most Americans do too.

At last we may be getting help from provisions of the new federal health care legislation that seek to support primary care doctors in their work to keep us healthy. The new law understands what the medical profession knows from studies. Mortality rates dip by 19 percent, and costs drop by one- third when Americans have their own primary care doctor.

The new legislation encourages an approach to primary care known as "medical home." I have supported this type of patient-centered care for many years and continue to work for the improvements it can bring to the quality of care you and I and our families receive. Thanks to support from the American Academy of Family Physicians, the American Academy of Pediatrics, and others, 39 states already have medical home practices in place and the results are encouraging.

The medical home puts the family doctor at the center of family care again. It puts in place technology such as electronic health records and new payment structures, which reimburse primary care doctors for their roles coordinating care. This model delivers preventative care, helps patients navigate a complex health system and manage chronic conditions while it helps lower costs.

The medical home model can reduce emergency room visits by as much as 50 percent and can contribute to a 40 percent reduction in hospitalization for individuals with chronic illnesses such as asthma.

Two major innovations are at work:

  1. Primary care doctors are paid for performing essential functions, such as taking medical histories, helping patients manage chronic conditions, providing advice and preventive care, as well as being more accessible to patients via the telephone and e-mail. No longer are they paid only for performing tests and procedures.
  2. Second, technology becomes a helpmate. Electronic health records and Web portals bring 21st century efficiencies to patient information. Getting a notice out to patients for an annual check-up or mammography is a quick click. Patients can get lab results online. When a patient has a serious illness, a primary care doctor can coordinate care with nurses, other doctors, pharmacists and physical therapists.

To improve the quality of the health care my wife and our family, and you and your family receive, we need to put the focus back on primary care.

Each one of us needs to have a doctor that treats our whole person, not only our heart or lungs or gallbladder.

It's time to bring more innovative approaches, such as the medical home, to primary care to help doctors do their jobs the best way possible. We will all be better for it. And, next year my cat may no longer be the only member of my family to get annual reminders for preventive care.

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