As Robert Lowes in a Medscape article today states: “Medical Home Guidelines Protect Physician Turf.” Various powerful national physician organizations continue to be hard at work lobbying for strict language in health care legislation and accreditation body standards for physicians to direct all medical practice within designated medical homes—also known as Patient-centered Medical Homes, Health Care Homes, and Primary Care Homes. Basically all of these terms refer to sensible first line “primary” health care that is comprehensive, coordinated, and accessible, and patient-centered. The Joint Commission adds the necessary ingredient of “a systems-based approach to quality and safety.”
Most people can agree that we need more of this type of health care in our country. But physician’s groups are trying to keep a monopoly on the increased reimbursement money that comes with having a medical home designation, by ensuring that medical homes are “physician directed medical practices.” Model nurse-led clinics, such as Ruth Lubic’s Family Health and Birth Center in northeast Washington, DC, and Patty Gerrity’s 11th Street Clinic in Philadelphia provide accessible cost-effective, comprehensive, quality health care to underserved urban populations. Take a look at the You-tube 5-minute clip “College of Nursing and Health Professions 11th Street Clinic” for an excellent overview of the care they provide. Also look at the 4-minute You-Tube interview “Ruth Lubic” to hear an inspiring “true” nurse leader—winner of a MacArthur “Genius Award—who used the award to do something about the abysmal health inequities for African American women and their babies in the shadow of the US Capitol. Ruth also won the 2010 “Foremother’s Award” from the excellent and thought-provoking Disruptive Women in Health Care (www.disruptivewomen.net). A Genius and a foremother and an all-around amazing woman whose work and life I admire.
Clinics like these can’t be run on a string of Genius Awards. They need to receive the official designation of medical home or primary care home or whatever name government at accreditation bodies want to give it, so they can keep providing the needed health care to their communities.
The Joint Commission has introduced more neutral and inclusive language in their Primary Care Home accreditation program. They use the term “primary care clinician.” The AMA and other groups are criticizing them for not using the term “physician-led.”
Ruth Lubic is 85 years old and is still working full-time to keep the Washington, DC clinic afloat and advocate for health care changes. As she said during testimony at the launching of the IOM Future of Nursing Report meeting in Washington, DC this past November, she wants to live to see her clinic able to get medical home designation. Help her out by doing a 5-minute survey, telling the Joint Commission what you think about this. They are seeking public comment through March 14th.
The direct link to The Joint Commission’s Primary Care Home Accreditation Project, which includes the link to the proposed accreditation criteria and the feedback survey, is http://www.jointcommission.org/accreditation/pchi.aspx
JOSEPHINE ENSIGN 