Once again Barbara Starfield beautifully describes how we might as a nation achieve meaningful health care reform (from her article in Family Practice Management).
She describes the inadequacies of the NCQA's proposed definition of technology as the medical home and instead proposes the deeply evidence-based attributes of primary care:
- First contact care, which requires accessibility and responsibility for reducing unnecessary specialist care,
- Person-focused care over time delivered by the patient’s chosen physician, who assumes responsibility over long periods of time for all health care,
- Comprehensiveness of care, and
- Coordination of care when people have to go elsewhere for problems outside the competence of the primary care practitioner.
I urge my colleagues to read this short but important piece.
How we deliver care matters. We have an opportunity to change the way we work, to live up to the full promise of primary care. The IMP Project has demonstrated our willingness & ability, but we can't do it alone. We need meaningful reform of the way money flows inside health care so that we are supported and not punished for doing this work.
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