We are in the process of setting up a patient centered medical home(PCMH) for our internal medicine resident continuity clinic. For the longest time, the PCMH seemed like a nebulous concept for me. If someone asked me what it was, I’d have a difficult explaining it. But after spending time reading the literature, I have a better idea . But now that we’re building it for our residents, we have to explain it to them. This can always be a challenge, especially when the PCMH redefines how we deliver care. Residents are already used to doing things a certain way, and concepts that require behavior change and extra effort can sometimes be a tough sell (for trainees and patients for that matter).
In patient care, it’s easy to get caught up in the details. I often advocate that the residents take a step back, and give the patient a big picture perspective. This is my big picture perspective on the PCMH.
It’s starts with the notion that the way we practice medicine isn’t very good. Considering, how much money we invest in healthcare, most metrics indicate we don’t get nearly as much for our healthcare dollars as many other nations do.
I liken our health care system to a custom made exotic car. It’s expensive. It’s got components of all the great cars. You take the best parts of a Ferrari, Aston Martin, Porsche, Mercedes. Lamborghini, Bugatti, you’ve got our health care system. It’s potential is incredible. Despite it being an incredibly powerful machine, it is limited by one crucial factor. It is the driver. We have terrible drivers.
And that’s what I want the PCMH to be for our resident trainees.. It’s driving school. It’s learning a new and better way to drive this car. It’s learning about how all the custom made components work together. It’s about making each patient’s journey in this vehicle a better one. It’s simply about delivering better care.