Medical Home Advantage
But Dr. J. Fred Ralston Jr., incoming president of the American College of Physicians, thinks that the patient-centered medical home, if fairly compensated, should be able to attract and retain doctors in general internal medicine. As a care delivery model, the medical home can provide care for a greater number of patients—an advantage that will be especially important as more people gain insurance coverage under the new health care reform law, he said.
The ACP has no official position on the concierge or retainer medicine practice model. Dr. Ralston said that as a practicing physician in Fayetteville, Tenn., he understands the frustrations that drive some physicians to choose the concierge model. But for its part, the ACP position is that the patient-centered medical home is an excellent care model to improve both patient care and primary care practice.
Both the medical home model and concierge care allow physicians to spend more time with patients. However, the medical home relies more heavily on a multidisciplinary team of providers than the concierge model, and thus will allow physicians to reach far more patients, Dr. Ralston said.
“Practicing this way has been a personal revelation for me,” said Dr. Jon Yardney, who now has fewer than 500 patients in his Wayne, Pa., practice.