CAPE ELIZABETH – Today, doctors across the country abide by a 15-minute rule of thumb when scheduling your visit. As we all know, during these 15 minutes doctors are trying to address chronic care, preventive care and acute care all in one short window of time.

One of the reasons for these tightly scheduled blocks is administrative work has begun taking up to 30 percent of doctors’ time. These administrative tasks, coupled with financial responsibilities and time pressures, continue to force doctors to spend less and less time with patients.

From my experience, doctors and patients want to be able to have meaningful dialogue about everything from complicated chronic diseases to overall well-being.

It is no wonder that patient-doctor relationships have changed so dramatically over the past 20 years, leading to less satisfaction among doctors as well as patients.

Recently, Maine physicians discussed this challenge during the Martin’s Point Innovator Series. During the meeting, they examined how some forward-thinking states are re-examining the importance of primary care and the role primary care physicians play in patients’ lives.

Maine is one of those states and is at the epicenter of a powerful new concept in patient care garnering attention from Washington, D.C., and across the country. This innovation in primary care — the patient-centered medical home — is paying off in better health care, lower costs, and happier doctors and patients.

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The approach is simple in that it centers on a patient’s total care, starting with wellness — the prevention of illness — through a primary care physician.

The primary care physicians then help manage all their patients’ health needs, including coordinating care with other health professionals.

This special patient-doctor relationship is particularly effective when dealing with chronic illnesses such as diabetes, heart problems and depression, which account for some 80 percent of our nation’s health care expenditures.

The medical home concept also focuses on high quality by reimbursing doctors for providing “quality care” versus the number of patients they see each day. This is a critical step in promoting health and wellness across the country since studies show that when people have a primary care doctor as their central source of care, their health care costs one-third less and they have a 19 percent lower mortality rate.

In communities across the nation, employers, health insurance companies and primary care doctors are coming together to improve how primary care is delivered.

A Washington state pilot program saw a 20 percent drop in emergency room visits. A North Carolina project experienced a 40 percent drop in hospitalizations for asthma and a 16 percent drop in emergency room visits.

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Maine’s own patient-centered medical home pilot is entering its second year. The enthusiasm for participation in the pilot was overwhelming at the onset with one in 10 primary care practices signing up. Ultimately, 26 practices across the state were selected to kick things off in January 2010.

Since then, the three-year pilot program has seen some early encouraging results. For example, major payers in Maine (Anthem BCBS, Aetna, CIGNA, Harvard Pilgrim Health Care, and MaineCare) have agreed to implement a new payment model for participants by adopting a “per member per month” care management fee.

At Martin’s Point Health Care, based in Portland, many patients have noticed some changes in the way doctors manage their care. One of the biggest changes has been the building of teams with doctors and physician assistants who manage a patient’s needs together.

Martin’s Point also utilizes electronic health records and other health and information tools to help make the health care system easier to navigate for patients and physicians.

In all of this, the aim is better care, fewer hospitalizations, and more effective use of resources by keeping patients healthier. This includes taking the needed time for each individual patient, building a trusting relationship, and helping patients manage their health for the long haul.

Taking advantage of smarter technology to create networks of connected information that lead to better care is an important goal for all. It can help consumers navigate the increasingly complicated health care system at a time when complexity keeps growing.

The research clearly shows that improved primary care is good both for people’s health and their wallets. As patients, we should get engaged with our health care providers and let them know this type of focused care is something we’d like more access to.

– Special to the Press Herald

 


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