Patient Care 101: back to basics

  • Published
  • By Lt. Col. Alison Helmkamp
  • 22nd Medical Group medical staff chief
The 22nd Medical Group Family Health Clinic was excited to join with the rest of the Air Force Medical Service this past year in beginning a new way of practicing primary care: the patient centered medical home.

This paradigm shifted the practice of medicine back where it belongs, to the patient and to maintaining and improving health. In fact, this is not a new notion; most small medical practices behave this way, and the American Academy of Family Practitioners declared this to be the right way to practice medicine back in 2002.

So, why the change, what's the fuss and how does it benefit our patients? Here are the basics.

A PCMH is a team-based model of care led by providers (in our case, a physician and a physician's assistant or nurse practitioner) who coordinates care throughout a patient's lifetime to maximize their patients' health. Other team members, including a registered nurse and five medical technicians, are critical to meeting the needs of our patients. All health care needs are addressed by the team, including coordinating specialty and urgent or emergent care. Treatment of chronic and acute illnesses goes hand in hand with preventive health measures and patient education, from birth to end-of-life issues.

The measures of success and the benchmarks our provider-led teams are responsible for are quite different from past times. No longer is the measure of success how many appointments we are able to squeeze into a workday. Instead, the AFMS now measures us on four elements:

1. Continuity: our patients should expect to see a provider on their team at each appointment. This is critical to coordination of care and attention to preventive measures, and greatly speeds the appointment since the patient doesn't have to re-explain everything.

2. Access: Our patients should have access to their teams. Of course, the hours in the day are not unlimited, so occasionally patients with acute illnesses may need to be seen by another team or an urgent care facility off base, but at the least, patients should be able to speak with a member of their team for medical advice.

3. Satisfaction: Believe it or not, the surveys count! Suggestions made are often acted on, kudos and complaints are sent to appropriate supervisors or commanders and often we change our processes for the better.

4. Population health metrics: Our teams ask all those pesky questions about labs, mammograms, tobacco use, vaccines, etc, for a reason: prevention is so much healthier and more efficient than treatment! The AFMS keeps track of all these numbers and provides us with databases that have information on when these health maintenance tasks were completed.

If you have noticed a change in the way the 22nd MDG does business, terrific! Our patients will probably notice a difference throughout the group as we embrace this initiative. We all know that this is the "right" way to take care of people and are excited to be making these changes.