Dearth of Primary Care Docs Threatens Provisions of Medical Home Model

John Commins, for HealthLeaders Media , November 12, 2010

"The cumulative time spent by specialists on routine chronic care is not trivial," says the study's senior author David C. Miller, MD, an assistant professor of urology at the U-M Medical School. "As a urologic oncologist, I take care of many cancer survivors. With a detailed care plan constructed by the treating oncologist, much of the follow-up care for these patients could potentially be assumed by a primary care physician-directed medical home, with appropriate referral back to me if problems or questions arise."

The study analyzed data from the 2007 National Ambulatory Medical Care Survey for seven chronic conditions: chronic obstructive pulmonary disease/asthma, low back pain, diabetes mellitus, coronary artery disease/congestive heart failure, chronic kidney disease and depression. Researchers examined the time specialists spent with patients for direct and indirect follow-up care for those conditions.

The study was funded by the Robert Wood Johnson Foundation Clinical Scholars Program and the Agency for Healthcare Research and Quality.


John Commins is a senior editor with HealthLeaders Media.
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