tag:blogger.com,1999:blog-3946741689271235070.post737000191423613735..comments2023-09-17T00:44:15.316-07:00Comments on DrDialogue: Can the Patient Centered Medical Home Save Primary Care?Juliet Mavromatis, MDhttp://www.blogger.com/profile/15621812541697154967noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-3946741689271235070.post-42455569487726249982011-07-04T09:59:53.752-07:002011-07-04T09:59:53.752-07:00Dr. Liu's choice and organization are a perfec...Dr. Liu's choice and organization are a perfectly valid way of approaching the PCMH goals but my impression talking with many physicians is their goal wasn't to "work for the man." Rather, many of them like the independence of private practice. Unfortunately, the independence that existed with the Marcus Welby model has been greatly compromised by encumbering day-to-day medicine with insurance bureaucracy.<br /> <br />Just last week, I was in the office of one of the mass-market versions of "concierge medicine" that I wrote about in an article published on WashingtonPost.com and TechCrunch. See http://techcrunch.com/2011/06/19/the-most-important-organization-in-silicon-valley-that-no-one-has-heard-about/. While I was there, a new patient signed up for the $49/mth service MedLion provides (no insurance - this is the total fee + $10/visit). He was uninsured as the latest price increase from his Kaiser plan had priced him out of the market. As a middle-aged man with a chronic condition, this model proved critical for him.<br /><br />I'm inspired by many organizations such as MedLion looking to rapidly expand their successful model. While the Health Insurance industry has the lowest average industry Net Promoter Score (NPS), orgs such as Qliance have NPS higher than Google or Apple showing you can provide outstanding care at a great price.Davehttps://www.blogger.com/profile/04377557996598577175noreply@blogger.comtag:blogger.com,1999:blog-3946741689271235070.post-89818580022181518822010-08-25T08:23:51.389-07:002010-08-25T08:23:51.389-07:00David,I enjoyed reading your blog on the medical h...David,I enjoyed reading your blog on the medical home model: http://davisliumd.blogspot.com/2010/08/why-solution-to-primary-care-crisis.html. I am curious about your vision: "instead, third party organizations should be accountable for managing chronic conditions and reporting to a patient's primary care doctor if the patient is not compliant with care or not following practice protocols." My view is that third party management (insurance company generated feedback reports) is not very effective in terms of inspiring quality improvement. Most doctors tend to ignore these types of reports unless they themselves generate the reports, or their own health care organization generates them. I guess that I am less pessimistic than you about the future ability of small practices to use electronic records and interconnect in a meaningful way to larger referral centers and specialists. I think that this will come eventually with meaningful use.Juliet Mavromatis, MDhttps://www.blogger.com/profile/15621812541697154967noreply@blogger.comtag:blogger.com,1999:blog-3946741689271235070.post-62820128870371138672010-08-24T06:42:16.646-07:002010-08-24T06:42:16.646-07:00I don't believe that the PCMH will solve the p...I don't believe that the PCMH will solve the primary care crisis (http://www.kevinmd.com/blog/2010/08/americans-doctors-physicians-leaving-primary-care.html). Though I understand the appeal of concierge medicine, this will not solve the primary care crisis on a national level.<br />-- <br />Davis Liu, MD<br />Author of Stay Healthy, Live Longer, Spend Wisely: Making Intelligent Choices in America's Healthcare System<br />(available in hardcover, Kindle, and iPad / iBooks)<br />Website: www.davisliumd.com<br />Blog: www.davisliumd.blogspot.com<br />Twitter: davisliumdDavis Liu, MDhttp://www.davisliumd.blogspot.comnoreply@blogger.com