Capsule Commentary on Aysola et al., Asking the Patient About Patient-Centered Medical Homes: A Qualitative Analysis

Excerpt

The patient-centered medical home (PCMH) may be the greatest revolution in care delivery that patients have never heard of. The PCMH care model aims to transform the organization and delivery of primary care by putting patients at the center of a care team that provides coordinated, evidence-based care—care that is delivered when, where and how patients want it.1 Full adoption of the care process has been stymied by pay systems that reward visits and procedures and may have disincentives for providing population-based care.2 However, as Aysola3 and colleagues point out, “patients uniformly lack awareness of PCMH concepts even when their care delivery system is a PCMH.” Why is this so? Aysola provides a clue: the most important aspect of primary care delivery to patients is their relationship with an individual provider, not a health system. Even when care was delivered through systems that highlighted team-based care, patients saw other members of the team as secondary to the interactions they had with their doctor. The intimacy and immediacy of the relationship between a primary care provider and their patient is not likely to be subsumed by redesigning systems to highlight team-based care. Patients consistently demonstrate loyalty, high satisfaction and trust with their primary are provider.4 ^, 5 Aysola concludes that practice redesign needs to preserve and build around this relationship. …