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The American Academy of Pediatrics has long advocated that every child have a "Medical Home" to guide their health throughout childhood. A pediatrician or primary care doctor can fill this need. With all the changes in medical science, new vaccines, and new health dangers being discovered, it's hard for parents to assure the good health and safety of their children. Emergencies come up, kids get sick, weird questions come up. Who can you always turn to for reliable advice?
Every child has unique problems with needs that are best met by having a long-term relationship with a doctor who is also a friend. Maybe even part friend and part family. That is the concept of a Medical Home.
In Scandinavian countries the Medical Home is a physical building that houses the doctors and specialists who serve the population in the immediate neighborhood. In the US we are more mobile, and like to have greater choice in who we pick for a doctor. Sometimes we have to change doctors, due to insurance, travel distance, or personality clashes. But our goal should be to find a working relationship with a primary care doctor or clinic, and establish that as your Medical Home over the long run. This results in far superior quality of care for obvious reasons.
What are the ways that we break down the Medical Home?
Jumping from doctor to doctor is bad for your health! The new doctor does not know your medical history and has to start from scratch to figure out what your health needs are.
Going to the Emergency Room also breaks down the Medical Home, because treatments may be given that your primary care doctor dos not agree with. The ER physician does the best he can, but does not know anything about your child's medical history. ER doctors may look like they have super powers on TV, but in real life they are generally not trained in pediatrics, and may not know the proper treatments for children.
Sometimes a visit to the ER is necessary, but you should always call your "home base" doctor first. Many times your own doctor can tell you what to do without going to the ER. Or if he directs you to the ER, he can call the ER doctor to guide the treatment.
What are the traits of a good Medical Home?
Your Medical Home needs to be accessible at any time, every day of the year. If your usual doctor is away he will have another doctor who fills in ("on call"). There should be a 24-hour phone number you can always call.
You should be able to get in to see the doctor for an illness any day that he is in the office. Doctors who promote the Medical Home keep openings in their office schedules to allow for sick children to be seen the same day. This is called "open scheduling".
If your doctor is not in the office, you should still be able to talk to him or the on-call doctor, and discuss the best options for dealing with your child's illness or problems.
Your Medical Home also provides guidance on the latest medical treatments and preventive health practices. Regular check-ups can get your child's shots up-to-date, check on screening tests that need to be done at certain ages, assess your child's development, follow up on any unique problems that your child may have, and gives a chance for you to ask questions about your child's health.
A good Medical Home can also provide timely information about health, such as the information you can find in this web page. Some doctors provide a newsletter, or write a column in the local newspaper. There are many ways that doctors can share important health information with their patients.
