Physician Practice Too Small for a PCMH? Think Again

Philip Betbeze, for HealthLeaders Media , January 21, 2011

His was the only practice in the state to be selected. It's how he got his practice's electronic medical record, and it's where he developed a holistic method for treating chronic conditions among his patient population. After that demonstration ended in 2008, he got into a state-level medical home and chronic care initiative. The chronic care model backs into the patient centered medical home construct, he says.

"Patient centeredness doesn't mean doing what the patient wants. It's about having the time to reestablish a relationship and understand what's going on through the patient's eyes, and seeing the patient in the context of community and support systems," he says. "It means having the time to get to know the patient the way we used to do it before it became a volume business where it was necessary to see 40-50 patients a day."

He's hired two RNs who are "case managers slash health coaches slash office-based experts," he says. In addition, there is now a practice administrator and medical assistants.

In hindsight, he's glad the experiment with the hospital-owned practice didn't work out.

"Had they not mistreated me, I wouldn't have had the gumption to start my own practice and would have never gotten involved with this movement," he says. "It was expensive to do what we did, and there's no real reimbursement. Salaries haven't gone up, but we're not in it for making lots of money. I've always wanted to do this--it just took me 25 years."

Philip Betbeze is senior leadership editor with HealthLeaders Media.
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