I recently had a great chat with John Erwin of CareNet, a company that helps insurers and doctors do the heavy lifting needed to build the medical home model.

The medical home model is one of those things that makes so much sense that you slap your forehead and say, “Why didn’t I think of that?” Basically, the model involves making primary care doctors the cornerstone of the health care system, or as Erwin put it, “funneling everything through your doctor.”

Why? Because, he said, “studies show that most patients say their primary doctor is their most trusted party – upwards of 80% -- so it makes a lot of sense, and that’s how [health care delivery] started. But over the years, we’ve pulled away from that to [focus on] who pays who and where’s what claim.”

Although the medical home model is intuitive, there’s a couple problems. The first is that the number of primary doctors, already insufficient, is shrinking, since medical students (many racked with educational debt) increasingly are choosing to specialize – which pays better -- rather than pursue primary care. The second problem is that should health care reform pass, an already stretched-thin group of primary care doctors could see an influx of millions of new patients.

However, under the medical home model, “instead of spending an average of seven minutes with patients, we’re asking [primary doctors] to spend 30 minutes or more,” Erwin explained. “Logistically, how does this work? It’s challenging, but that’s where an opportunity arises for companies like ours.”

The potential gain for his company aside, Erwin admitted he doesn’t “think there’s going to be enough doctors fast enough to provide 100% hands-on care. But all the discussion on health care reform has really highlighted some of those needs. If we want true universal coverage, we’re all going to have to give something up. If everyone comes to the table, we’re all going to get a little less.”

What do you think? Comment and let me know.

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