Dr Cooper: I’ve never thought about it quite like this. But what you say makes perfect sense. 

So, how does the overall trend toward convenience care, in its rainbow of shapes and configurations, square with the patient-centered medical home model of care which is espoused by the American Academy of Family Physicians and other primary-care organizations?


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Dr Mehrotra: I see two trends developing. The patient-centered medical home model is supposed to address nearly all aspects of a patient’s care, including preventive care, chronic disease management, medications, referral to subspecialists, and acute care. If a patient is acutely ill he or she can get an appointment quickly — ideally the same day. The idea is to reduce the need for ER visits and hospitalizations, and to serve the patient quickly upon discharge from the hospital to help prevent readmissions.

This model is comparable to the service offered by large department stores, where the consumer can pretty much find whatever he or she wants in one place — the “one-stop shopping” idea.

But family medicine has become a specialty in its own right. So you may, for example, have a patient who goes to her family doctor periodically for her hypertension or hypothyroidism. But she may also go to a telemedicine company for her contraception, get counseling for her mental health issues on the web, visit a retail clinic for her flu shot, and go to an urgent care clinic for treatment of her UTI. 

In each case, she’s going to the place that offers the service she needs and at the time she needs it. She has more choices than ever before.

Dr Cooper: So today’s healthcare consumer may put access to care and choice ahead of a totally integrated model of care?

Dr Mehrotra: It seems to be trending in that direction. Let’s face it — people are busy these days, and there are only 24 hours a day in their busy lives.

Many technological innovations in our society, such as online banking, online shopping, drive-through coffee, and other faster options for service, are playing a role in this trend

There’s a difference in expectations regarding how long consumers are willing to wait for medical care. Waiting two or three days to see a doctor 20 years ago may have been acceptable, but not anymore.

Dr Cooper: Thank you for a very illuminating interview.

Dr Mehrotra: And thank you for the opportunity to communicate with your audience.

 

About Ateev Mehrotra, MD, MPH

Ateev Mehrotra, MD, MPH, is an associate professor of health care policy and medicine at Harvard Medical School and a hospitalist at Beth Israel Deaconess Medical Center. He received his BS from MIT, medical degree from UC, San Francisco and residency in internal medicine and pediatrics at Massachusetts General Hospital and Children’s Hospital of Boston. He also earned a Master of Public Health from the University of California, Berkeley and a Master of Science in Epidemiology from the Harvard School of Public Health.

 

About Joel Cooper, DO

Dr Cooper is a contributing writer for The Medical Bag and a board-certified family physician currently working in urgent care in the Phoenix area.

Reference

  1. The US Market for Urgent Care Centers. Kalorama Information. Updated 2017. Available at: http://www.kaloramainformation.com/ . Accessed April 25, 2017.

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