A medical home is a partnership between you and your child’s doctor that makes sure your child is getting the best possible care. It is not an actual place or building you can go to. The word home means that you have a “home base” for your child’s health care needs. The medical home concept has been growing more and more in the last few years and creates a coordination “team” around the medical needs of your child.
The place where you usually take your child for health care can be your child’s medical home. Medical homes don’t happen right away and don’t always look the same. No matter who provides coordination a medical home provides support for your child and help for you as the parent or guardian in the coordination of care. If you would like to work on creating a medical home for your child often the first place to start is with your child’s primary care physician to see if they are familiar with how to coordinate care around your child. Some families have medical homes built through a specialist’s office, some a primary care pediatrician, and others who are on Medicaid can have that coordination through a managed care patient care specialist.
When choosing a provider to help you create a medical home here are some tips to consider:
- Their willingness to negotiate and respect your input and decisions
- That your child’s best interest is at the heart of their care and that the family’s dynamics are taken into consideration when a care plan is put into place
- Your provider has at least some experience with your child’s condition. The relationship of the provider with your child is the most important element.
- Open communication so that you and your doctor can make decisions together and that you are recognized as the expert on your own child’s care
It is important that the provider you consider also work well with the other members of your child’s care team and that they are willing to communicate and share information. You and your child’s providers should make decisions together calmly and information should be shared with all members of the team. A willingness to work with supports inside and outside the medical profession is also something to think about. A physician that is willing to work with a school and advocate for the child’s needs in a school environment goes a long way in setting up a strong IEP or 504 education plan.
When working with a provider understand that respect is a two-way street. Working with complex needs can be frustrating and scary and just because someone is a physician doesn’t mean they have all the answers. Asking questions and letting your provider know that you don’t understand their decision or don’t agree with their decision can be done respectfully and can help to build a strong line of communication if it is done with respect. You are the driver of your team so it helps to come from a place of respect.
It also helps to respect the time utilized in appointments as well. Be sure and let the office know ahead of time if you need more time in an appointment and write out your questions and concerns ahead of time. If you have a teenager or young adult start having them write out their questions and needs as well so that they become a part of the team in managing their own care.
I know it seems like a lot of work but there are a great deal of reasons why a medical home is of benefit. Some of these reasons include:
- Help in the early identification of special health care needs
- Provides ongoing primary care
- Ongoing coordination with a broad range of other specialty services
- Your child’s doctor can help you find more medical services for your child
- More cost effective
- Your doctor will get to know your child’s needs better
- Your child will get better healthcare because you and your doctor have a partnership
- Information is shared between you and your child’s doctors
- You and your child’s providers can build a relationship
- Fewer visits to the emergency room and hospital when problems are found more quickly
- Lower long-term health care costs
Family can be a constant in many children’s lives. They know the history of the child and they will be there in the future. Bringing a trusted medical provider into that circle to help with the coordination and care of your child frees you, as a family, to look beyond the need to juggle the many complex issues of caring for a child with special healthcare needs. A medical home can spread the burden of coordination and decision making between many hands and can keep everyone on the same page. This alone can be worth the extra work that you may face in beginning.
There are some great web resources around establishing a medical home both at national and state sites and you can access them below.
American Academy of Pediatrics
Washington State Medical Home