Deborah M. Mullen, Ph.D., is the Greg A. Vital–Franklin Farrow Associate Professor of Health Care Management at the Gary W. Rollins College of Business at the University of Tennessee (UTC) at Chattanooga. She has worked in health care delivery organizations (clinics, hospitals, and insurance companies) for over 25 years in operations, analytics, management, and research. She joined UTC in 2018 and teaches health care and strategic management courses.
"My focus, whether research or teaching, is always on the person and the community. I think the promise of health care is making it possible for people to live the life they want, not one defined by illness," she says. "Chattanooga offers wonderful natural and community assets, as well as opportunities to build an even stronger and healthier community."
Q: What is a medical home?
A medical home is a health care model built through an on-going relationship between a patient and their primary care team. Your team gets to know you and your family, and personalizes their recommendations to help meet your needs and goals. It is considered to be "patient-centered," as you are at the heart of the care. The team may include a doctor, physician's assistant, nurse practitioner and other care team members.
Q: I am healthy. Why does it matter?
If you are in general good health, you may wonder why having a primary care medical home might matter. Even people who are well will, at some point, need the advice of a doctor. When you read a medical website or watch a commercial for a medication, they all give the same disclaimer at the end -- "Talk to your doctor." Why? We all are different, and a specific course of treatment may or may not be the right one for you. When you need advice, it is always better to seek it from someone you trust and who knows your health background.
Q: I use e-doctors, quick clinics, urgent care, or the emergency department when I need help. Why would I bother with setting up a medical home?
We can all agree, when we don't feel well, we want help right away. No one likes to feel under the weather. Research over the past 15 years has found that having a medical home saves you time, and provides better support, communication and accessibility. There is nothing wrong with the excellent care that you will receive using an e-Dr, quick clinic, urgent care or the emergency department. These facilities are built to help with acute, short-term illnesses and are not normally designed to support patients long-term with chronic illnesses.
Obviously, the emergency room is always the place to go when you have a life-threatening and severe health condition. Most of us will pay an expensive co-pay for emergency department care. But if there are sicker patients in the queue in front of you, it can be a long wait.
Urgent care clinics are a good place to seek care at hours when primary care clinics are closed for non-life threatening problems like sprains, strains or cuts requiring stitches. Urgent care can have longer waits since they are often first come, first served.
Quick clinics located within pharmacies or large box stores offer a shorter list of primary care services such as vaccinations, acute injuries (sprain, strains, and stitches), infection, medical testing, physicals and some chronic care. Quick clinics and internet (e-Dr) can be more affordable (normally lower co-pays than ED or urgent care) and can be available either online or in-person.
These kinds of clinics and e-Drs, which many people tried for the first time during the pandemic, are an easy and quick way to seek care, but aren't set up to provide the full services of a primary care facility. These are great options when you are not well and the clinic is not open, or when you find yourself sick while out of town, for example. A medical home primary care office adds to your care by offering comprehensive services for prevention, chronic disease support, and mental and physical care. Because your medical home has all your data and knows you, they can make it easier to get the right care at the right time. They offer coaching, support, comprehensive care plans and can help you find community supportive services.
When you have the relationship with your medical home team, they provide faster communication via patient email portals, phone follow ups and 24-hour-a-day coverage by a group that knows you. They coordinate care when you need to see a specialist. Because they know your history, a primary care medical home can make referrals to specialists who are a good match, rather than choosing a name on a list from your insurance company. An added bonus of medical home care is that many offices have an electronic medical record system, so your medical information is readily available.
Q: Why should I pair my medical home with a specific pharmacy?
If you take many medications, there is a potential that you may need adjustments to avoid drug interactions. When all your medications come from a single pharmacy provider, they can help your care team review your medications. A comprehensive medication list helps your pharmacist support your care team, ensuring you receive your best care.
Q: What are examples of what a medical home can offer that other care facilities might not be able to?
Many people put off medical care due to concerns about COVID-19, which is something care teams understand. They can help you get caught up with missed preventive services and help prioritize what needs to happen first. With more people experiencing distress and anxiety due to economic and pandemic pressures, your medical home can help offer resources specifically suited to you.
Many women wonder when to start getting mammograms. This decision is best made with your medical home team, which might be your OB/GYN. There are many reasons why you may need to start having screening mammograms at a different time than your friends. Your medical home can help you evaluate the information, your health, family history, risk factors, and make a personal recommendation. People have different health goals and bodies -- and a personal plan is the best plan for you.