Wednesday, May 7, 2008

Just What Were They Thinking When They Came Up With the Name 'Medical Home?'

Regular readers of the Disease Management Care Blog know, in contrast to the unquestioning adoration by many of the health policy mandarins, that it has had some reservations about the ‘medical home.’ As expressed in many prior posts, it’s not sure the MH is necessarily a stand-alone solution to the all the needs of persons with chronic illness, that it has a long way to go in addressing these populations’ insurance risk and that it’s been provocatively held up as a ‘white hat’ strategy that’ll bring big bad disease management and managed care to heel.

Here’s another reservation from the DMCB: the name ‘medical home,’ well, how to put this… well, it just plain... sucks. The DMCB understands the long-standing pedigree of the label and its many supporting references in the scientific literature. It is aware that multiple primary care entities have rallied around this particular banner. It knows it's been written into Medicare demos. It appreciates how the term makes the health care academics' hearts flutter. But it is not sure the term will play in Peoria.

Why? While the DMCB is no marketing genius, it wonders if the term ‘medical home’ will have any appeal to persons over age 50. At first glance, it thinks it will remind its potential customers of the other types of unappealing medical ‘homes’ that, deserved or not, have a reputation for housing persons who are otherwise unable to live independently. It also promises something that it is not: a setting that serves as a ‘Third Place.’ Younger persons are also unlikely to buy into the concept, since they probably think their medical home resides with them personally, not some brick and mortar clinic. Think putting 'patient centered' in front of MH will help? Does this mean there is medical care that is NOT patient centered? Egads.

When the DMCB thinks about it, what the ‘medical home’ devotees are really offering health care consumers is a combined librarian (who can aggregate disparate medical information in an individually useful format), concierge (a trusted advisor who can illuminate the right diagnosis and treatment path) and health care provider (broadened to include wellness and prevention) with a special emphasis on chronic conditions. The term 'medical home' captures none of these concepts for the average person.

Feel free to suggest alternative names. These guys need all the help they can get.

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